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Efficacy of 18F-FDG PET/CT in the evaluation of patients with recurrent cervical carcinoma

  • Erik Mittra
  • Tarek El-Maghraby
  • Cesar A. Rodriguez
  • Andrew Quon
  • I. Ross McDougall
  • Sanjiv S. Gambhir
  • Andrei IagaruEmail author
Original Article

Abstract

Purpose

Only a limited number of studies have evaluated the efficacy of 18F-FDG PET/CT for recurrent cervical carcinoma, which this study seeks to expand upon.

Methods

This is a retrospective study of 30 women with cervical carcinoma who had a surveillance PET/CT after initial therapy. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were calculated using a 2 × 2 contingency table with pathology results (76%) or clinical follow-up (24%) as the gold standard. The Wilson score method was used to perform 95% confidence interval estimations.

Results

The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of PET/CT for the detection of local recurrence at the primary site were 93, 93, 93, 86, and 96%, respectively. The same values for the detection of distant metastases were 96, 95, 95, 96, and 95%, respectively. Seventy-one percent of the scans performed in symptomatic patients showed true-positive findings. In comparison, 44% of scans performed in asymptomatic patients showed true-positive findings. But, all patients subsequently had a change in their management based on the PET/CT findings such that the effect was notable. The maximum standardized uptake value ranged from 5 to 28 (average: 13 ± 7) in the primary site and 3 to 23 (average: 8 ± 4) in metastases which were significantly different (p = 0.04).

Conclusion

This study demonstrates favorable efficacy of 18F-FDG PET/CT for identification of residual/recurrent cervical cancer, as well as for localization of distant metastases.

Keywords

PET/CT 18F-FDG Cervical cancer Restaging Efficacy 

Notes

Acknowledgements

This research was supported in part by NCI ICMIC CA114747 (SSG) and the clinical studies were supported in part by the Doris Duke Foundation and Canary Foundation (SSG).

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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Erik Mittra
    • 1
  • Tarek El-Maghraby
    • 2
    • 3
  • Cesar A. Rodriguez
    • 1
  • Andrew Quon
    • 1
  • I. Ross McDougall
    • 1
  • Sanjiv S. Gambhir
    • 1
    • 4
  • Andrei Iagaru
    • 1
    Email author
  1. 1.Division of Nuclear MedicineStanford Hospitals & ClinicsStanfordUSA
  2. 2.Nuclear MedicineCairo UniversityCairoEgypt
  3. 3.Nuclear MedicineSaad Specialist HospitalAl KhobarSaudi Arabia
  4. 4.Division of Nuclear Medicine, Departments of Radiology and BioengineeringStanford Hospital and ClinicsStanfordUSA

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