18F-FDG PET in the management of endometrial cancer

  • Angel Chao
  • Ting-Chang Chang
  • Koon-Kwan Ng
  • Swei Hsueh
  • Huei-Jean Huang
  • Hung-Hsueh Chou
  • Chien-Sheng Tsai
  • Tzu-Chen Yen
  • Tzu-I Wu
  • Chyong-Huey Lai
Original Article

DOI: 10.1007/s00259-005-1876-y

Cite this article as:
Chao, A., Chang, TC., Ng, KK. et al. Eur J Nucl Med Mol Imaging (2006) 33: 36. doi:10.1007/s00259-005-1876-y

Abstract

Purpose

Few studies have investigated the clinical impact of whole-body positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) in endometrial cancer. We aimed to assess the value of integrating FDG-PET into the management of endometrial cancer in comparison with conventional imaging alone.

Methods

All patients with histologically confirmed primary advanced (stage III/IV) or suspicious/documented recurrent endometrial cancer, with poor prognostic features (serum CA-125 >35 U/ml or unfavourable cell types), or surveillance after salvage therapy were eligible. Before FDG-PET scanning, each patient had received magnetic resonance imaging and/or computed tomography (MRI-CT). The receiver operating characteristic curve method with calculation of the area under the curve (AUC) was used to compare the diagnostic efficacy. Clinical impacts were determined on a scan basis.

Results

Forty-nine eligible patients were accrued and 60 studies were performed (27 primary staging, 33 post-therapy surveillance or restaging on relapse). The clinical impact was positive in 29 (48.3%) of the 60 scans. Mean standardised uptake values (SUVs) of true-positive lesions were 13.2 (range 5.7–37.4) for central pelvic lesions and 11.1 (range 1.5–37.4) for metastases. The sensitivity of FDG-PET alone (P<0.0001) or FDG-PET plus MRI-CT (P<0.0001) was significantly higher than that of MRI-CT alone in overall lesion detection. FDG-PET plus MRI-CT was significantly superior to MRI-CT alone in overall lesion detection (AUC 0.949 vs 0.872; P=0.004), detection of pelvic nodal/soft tissue metastases (P=0.048) and detection of extrapelvic metastases (P=0.010), while FDG-PET alone was only marginally superior by AUC (P=0.063).

Conclusion

Whole-body FDG-PET coupled with MRI-CT facilitated optimal management of endometrial cancer in well-selected cases.

Keywords

18F-FDG PET Endometrial cancer Primary staging Recurrence Salvage therapy 

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Angel Chao
    • 1
    • 2
  • Ting-Chang Chang
    • 1
  • Koon-Kwan Ng
    • 3
  • Swei Hsueh
    • 4
  • Huei-Jean Huang
    • 1
  • Hung-Hsueh Chou
    • 1
  • Chien-Sheng Tsai
    • 5
  • Tzu-Chen Yen
    • 6
  • Tzu-I Wu
    • 1
  • Chyong-Huey Lai
    • 1
    • 7
  1. 1.Division of Gynecologic Oncology, Department of Obstetrics and GynecologyChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan
  2. 2.Graduate Institute of Clinical Medical SciencesChang Gung UniversityTaoyuanTaiwan
  3. 3.Department of RadiologyChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan
  4. 4.Department of PathologyChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan
  5. 5.Department of Radiation OncologyChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan
  6. 6.Department of Nuclear MedicineChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan
  7. 7.Department of Obstetrics and GynecologyChang Gung Memorial Hospital Linkou Medical CenterTaoyuanTaiwan