Skip to main content

Advertisement

SpringerLink
Log in

Positron-emission tomography in gynaecologic malignancies

  • Review
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Introduction

The role of 18F-FDG PET in the management of gynaecologic malignancies remains unclear mainly due to the failure of clinicians to appreciate the significance of this imaging tool. However, this under utilisation is being actively re-addressed with a large number of reviews and studies, particularly in the last few years.

Methods and Results

PET has been shown to have high sensitivity and specificity in the evaluation of relapse and nodal disease in cervical cancer, while other uses such as staging and monitoring response to therapies being under further investigation. Similarly, promising results have been published in the use of PET in patients affected by endometrial cancer and uterine sarcomas for detecting lymph nodes metastasis and recurrent disease. In ovarian cancer, PET appears to have a great potential in staging and assessment of disease relapse. An important utility of PET in gynaecologic tumours, which is shared with a large number of other malignancies, is its value in positively changing the patients’ management.

Conclusion

The surge in studies using PET in gynaecological malignancies is in its early stages, and further studies are required to optimise the role of PET in these conditions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. http://www.cancer.org/downloads/STT/2008CAFFfinalsecured.pdf

  2. Greenlee RT, Murray T, Bolden S, Wingo PA (2000) Cancer statistics 2000. CA Cancer J Clin 50:7–33. doi:10.3322/canjclin.50.1.7

    Article  PubMed  CAS  Google Scholar 

  3. Hacker NF (2000) Vulvar cancer. In: Berek JS, Hacker NF (eds) Practical gynaecologic oncology, 3. Williams & Wilkins, Baltimore, pp 553–596

  4. Loar PVIII, Reynolds RK (2007) Sentinel lymph node mapping in gynecologic malignancies. Int J Gynaecol Obstet 99:69–74. doi:10.1016/j.ijgo.2007.06.001

    Article  PubMed  Google Scholar 

  5. Hauspy J, Beiner M, Harley I, Ehrlich L, Rasty G, Covens A (2007) Sentinel lymph node in vulvar cancer. Cancer 110(5):1015–1023. doi:10.1002/cncr.22874

    Article  PubMed  Google Scholar 

  6. Cohn DE, Dehdashti F, Gibb RK, Mutch DG, Rader JS, Siegel BA, Herzoq TJ (2002) Prospective evaluation of positron emission tomography for the detection of groin node metastases from vulvar cancer. Gynecol Oncol 85:179–184. doi:10.1006/gyno.2002.6605

    Article  PubMed  Google Scholar 

  7. Parkin DM, Bray F, Ferlay J, Pisani P (2005) Global cancer statistics, 2002. CA Cancer J Clin 55:74–108

    Article  PubMed  Google Scholar 

  8. Pandit-Taskar N (2005) Oncologic imaging in gynecologic malignancies. J Nucl Med 46:1842–1850

    PubMed  Google Scholar 

  9. Plummer M, Franceschi S (2000) Strategies for HPV prevention. Virus Res 89:285–293. doi:10.1016/S0168-1702(02)00197-1

    Article  Google Scholar 

  10. Baak JP, Wisse-Brekelmans EC, Langley FA, Talerman A, Delemarre JF (1986) Morphometric data to FIGO stage and histological type and grade for prognosis of ovarian tumours. J Clin Pathol 39:1340–1346. doi:10.1136/jcp.39.12.1340

    Article  PubMed  CAS  Google Scholar 

  11. Fanti S, Nanni C, Ambrosini V, Gross MD, Rubello D, Farsad M (2007) PET in genitourinary tract cancers. Q J Nucl Med Mol Imaging 51:260–271

    PubMed  CAS  Google Scholar 

  12. Wong TZ, Jones EL, Coleman RE (2004) Positron emission tomography with 2-deoxy-2-[(18)F]fluoro-d-glucose for evaluating local and distant disease in patients with cervical cancer. Mol Imaging Biol 6:55–62. doi:10.1016/j.mibio.2003.12.004

    Article  PubMed  Google Scholar 

  13. Roh JW, Seo SS, Lee S, Kang RW, Kim SK, Sim JS, Kim JY, Hong EK, Cho DS, Lee JS, Park SY (2005) Role of positron emission tomography in pretreatment lymph node staging of uterine cervical cancer: a prospective surgicopathologic correlation study. Eur J Cancer 41:2086–2092. doi:10.1016/j.ejca.2005.05.013

    Article  PubMed  Google Scholar 

  14. Wright JD, Dehdashti F, Herzog TJ, Mutch DG, Huettner PC, Rader JS, Gibb RK, Powell MA, Gao F, Siegel BA, Grisby PW (2005) Preoperative lymph node staging of early-stage cervical carcinoma by [18F]-fluoro-2-deoxy-d-glucose-positron emission tomography. Cancer 104:2484–2491. doi:10.1002/cncr.21527

    Article  PubMed  Google Scholar 

  15. Choi HJ, Roh JW, Seo SS, Lee S, Kim JY, Kim SK, Kang KW, Lee JS, Jeong JY, Park SY (2006) Comparison of the accuracy of magnetic resonance imaging and positron emission tomography/computed tomography in the presurgical detection of lymph node metastases in patients with uterine cervical carcinoma: a prospective study. Cancer 106:914–922. doi:10.1002/cncr.21641

    Article  PubMed  Google Scholar 

  16. Sironi S, Buda A, Picchio M, Perego P, Moreni R, Pellegrino A, Colombo M, Mangioni C, Messa C, Fazio F (2006) Lymph node metastasis in patients with clinical early-stage cervical cancer: detection with integrated FDG PET/CT. Radiology 238:272–279. doi:10.1148/radiol.2381041799

    Article  PubMed  Google Scholar 

  17. Yen TC, Lai CH, Ma SY, Huang KG, Huang HJ, Hong JH, Hsueh S, Lin WJ, Nq KK, Chang TC (2006) Comparative benefits and limitations of (18)F-FDG PET and CT-MRI in documented or suspected recurrent cervical cancer. Eur J Nucl Med Mol Imaging 33:1399–1407. doi:10.1007/s00259-006-0090-x

    Article  PubMed  Google Scholar 

  18. Chung HH, Jo H, Kang WJ, Kim JW, Park NH, Song YS, Chung JK, Kang SB, Lee HP (2007) Clinical impact of integrated PET/CT on the management of suspected cervical cancer recurrence. Gynecol Oncol 104:529–534. doi:10.1016/j.ygyno.2006.09.009

    Article  PubMed  Google Scholar 

  19. Yen TC, See LC, Chang TC, Huang KG, Ng KK, Tang SG, Chang YC, Hsueh S, Tsai CS, Lai CH (2004) Defining the priority of using 18F-FDG PET for recurrent cervical cancer. J Nucl Med 45:1632–1639

    PubMed  Google Scholar 

  20. Schwarz JK, Siegel BA, Dehdashti F, Grigsby PW (2007) Association of posttherapy positron emission tomography with tumor response and survival in cervical carcinoma. J Am Med Assoc 298:2289–2295. doi:10.1001/jama.298.19.2289

    Article  CAS  Google Scholar 

  21. Kitajima K, Murakami K, Yamasaki E, Fukasawa I, Inaba N, Kaji Y, Sugimura K (2008) Accuracy of 18F-FDG PET/CT in detecting pelvic and paraaortic lymph node metastasis in patients with endometrial cancer. AJR Am J Roentgenol 190:1652–1658. doi:10.2214/AJR.07.3372

    Article  PubMed  Google Scholar 

  22. Nayot D, Kwon JS, Carey MS, Driedger A (2008) Does preoperative positron emission tomography with computed tomography predict nodal status in endometrial cancer? A pilot study. Curr Oncol 15:123–125

    PubMed  CAS  Google Scholar 

  23. Chung HH, Kang WJ, Kim JW, Park NH, Song YS, Chung JK, Kang SB (2008) The clinical impact of [(18)F]FDG PET/CT for the management of recurrent endometrial cancer: correlation with clinical and histological findings. Eur J Nucl Med Mol Imaging 35:1081–1088. doi:10.1007/s00259-007-0687-8

    Article  PubMed  Google Scholar 

  24. Murakami M, Tsukada H, Shida M, Watanabe M, Maeda H, Koido S (2006) Whole-body positron emission tomography with F-18 fluorodeoxyglucose for the detection of recurrence in uterine sarcomas. Int J Gynecol Cancer 16:854–860. doi:10.1111/j.1525-1438.2006.00532.x

    Article  PubMed  CAS  Google Scholar 

  25. Park JY, Kim EN, Kim DY, Suh DS, Kim JH, Kim YM, Kim YT, Nam JH (2008) Role of PET or PET/CT in the post-therapy surveillance of uterine sarcoma. Gynecol Oncol 109:255–262. doi:10.1016/j.ygyno.2008.01.030

    Article  PubMed  Google Scholar 

  26. Sung PL, Chen YJ, Liu RS, Shieh HJ, Wang PH, Yen MS, Wen KC, Shen SH, Lai CR, Yuan CC (2008) Whole-body positron emission tomography with 18F-fluorodeoxyglucose is an effective method to detect extra-pelvic recurrence in uterine sarcomas. Eur J Gynaecol Oncol 29:246–251

    PubMed  CAS  Google Scholar 

  27. Smith LH (2006) Early clinical detection of ovarian cancer: a review of the evidence. Expert Rev Anticancer Ther 6:1045–1052. doi:10.1586/14737140.6.7.1045

    Article  PubMed  Google Scholar 

  28. American Cancer Society Cancer facts and figures: 1998 (1998) American Cancer Society, Atlanta, GA, 13

  29. Bragg DG (1993) Imaging in gynecologic malignancies. Cancer 71:1648–1651

    PubMed  CAS  Google Scholar 

  30. Yoshida Y, Kurokawa T, Kawahara K, Yagihara A, Tsuchida T, Okazawa H (2004) Incremental benefits of FDG positron emission tomography over CT alone for the preoperative staging of ovarian cancer. AJR Am J Roentgenol 182:227–233

    PubMed  Google Scholar 

  31. Castellucci P, Perrone AM, Picchio M, Ghi T, Farsad M, Nanni C, Messa C, Meriggiola MC, Pelusi G, Al-Nahhas A, Rubello D, Fazio F, Fanti S (2007) Diagnostic accuracy of 18F-FDG PET/CT in characterizing ovarian lesions and staging ovarian cancer: correlation with transvaginal ultrasonography, computed tomography, and histology. Nucl Med Commun 28:589–595. doi:10.1097/MNM.0b013e3281afa256

    Article  PubMed  CAS  Google Scholar 

  32. Kitajima K, Murakami K, Yamasaki E, Kaji Y, Fukasawa I, Inaba N, Sugimura K (2008) Diagnostic accuracy of integrated FDG-PET/contrast-enhanced CT in staging ovarian cancer: comparison with enhanced CT. Eur J Nucl Med Mol Imaging 35:1912–1920. doi:10.1007/s00259-008-0890-2

    Article  PubMed  Google Scholar 

  33. Avril N, Sassen S, Schmalfeldt B, Naehrig J, Rutke S, Weber WA (2005) Prediction of response to neoadjuvant chemotherapy by sequential F-18-fluorodeoxyglucose positron emission tomography in patients with advanced-stage ovarian cancer. J Clin Oncol 23:7445–7453. doi:10.1200/JCO.2005.06.965

    Article  PubMed  Google Scholar 

  34. Havrilesky LJ, Kulasingam SL, Matchar DB, Myers ER (2005) FDG-PET for management of cervical and ovarian cancer. Gynecol Oncol 97:183–191. doi:10.1016/j.ygyno.2004.12.007

    Article  PubMed  Google Scholar 

  35. Delbeke D, Martin WH (2001) Positron emission tomography imaging in oncology. Radiol Clin North Am 39:883–917. doi:10.1016/S0033-8389(05)70319-5

    Article  PubMed  CAS  Google Scholar 

  36. Nanni C, Rubello D, Farsad M, De Iaco P, Sansovini M, Erba P, Rampin L, Mariani G, Fanti S (2005) (18)F-FDG PET/CT in the evaluation of recurrent ovarian cancer: a prospective study on forty-one patients. Eur J Surg Oncol 31:792–797. doi:10.1016/j.ejso.2005.02.029

    Article  PubMed  CAS  Google Scholar 

  37. Takekuma M, Maeda M, Ozawa T, Yasumi K, Torizuka T (2005) Positron emission tomography with 18F-fluoro-2-deoxyglucose for the detection of recurrent ovarian cancer. Int J Clin Oncol 10:177–181. doi:10.1007/s10147-005-0489-6

    Article  PubMed  Google Scholar 

  38. Kubik-Huch RA, Dorffler W, von Schulthess GK (2000) Value of (18F)-FDG positron emission tomography, computed tomography, and magnetic resonance imaging in diagnosing primary and recurrent ovarian carcinoma. Eur Radiol 10:761–767. doi:10.1007/s003300051000

    Article  PubMed  CAS  Google Scholar 

  39. Menzel C, Dobert N, Hamscho N, Zaplatnikov K, Vasvatekis S, Matic V (2004) The influence of CA 125 and CEA levels on the results of (18)F-deoxyglucose positron emission tomography in suspected recurrence of epithelial ovarian cancer. Strahlenther Onkol 180(8):497–501. doi:10.1007/s00066-004-1208-3

    Article  PubMed  Google Scholar 

  40. Torizuka T, Kanno T, Futatsubashi M, Okada H, Yoshikawa E, Nakamura F, Takekuma M, Maeda M, Ouchi Y (2003) Imaging of gynecologic tumors: comparison of (11)C-choline PET with (18)F-FDG PET. J Nucl Med 44:1051–1056

    PubMed  CAS  Google Scholar 

  41. Van der Veldt AA, Luurtsema G, Lubberink M, Lammertsma AA, Hendrikse NH (2008) Individualized treatment planning in oncology: role of PET and radiolabelled anticancer drugs in predicting tumour resistance. Curr Pharm Des 14(28):2914–2931. doi:10.2174/138161208786404344

    Article  PubMed  Google Scholar 

Download references

Conflict of interest statement

None.

Author information

Authors and Affiliations

  1. Department of Nuclear Medicine, Policlinico S. Orsola-Malpighi, Bologna, Italy

    Anna Margherita Maffione, Charoula Stavroula Tsamita, Cristina Nanni, Paolo Castellucci, Valentina Ambrosini, Egesta Lopci, Alessandra Musto & Stefano Fanti

  2. Unit of Gynaecology and Obstetrics, Policlinico S. Orsola-Malpighi, Bologna, Italy

    Michela Piva

  3. Department of Radiology and Nuclear Medicine, Nuclear Medicine Unit and PET/CT Centre, ‘S. Maria della Misericordia’ Hospital, Viale Tre Martiri 140, 45100, Rovigo, Italy

    Lucia Rampin, Gaia Grassetto, Maria Cristina Marzola, Arianna Massaro & Domenico Rubello

  4. Department of Nuclear Medicine, Umberto I Hospital, Mestre, Venice, Italy

    Elena Cracco

  5. Department of Nuclear Medicine, Hammersmith Hospital, London, UK

    Adil Al-Nahhas

Authors
  1. Anna Margherita Maffione
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michela Piva
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Charoula Stavroula Tsamita
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Cristina Nanni
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Paolo Castellucci
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Valentina Ambrosini
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Egesta Lopci
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Alessandra Musto
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Lucia Rampin
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Gaia Grassetto
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Maria Cristina Marzola
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Arianna Massaro
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Elena Cracco
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Adil Al-Nahhas
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Stefano Fanti
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Domenico Rubello
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Domenico Rubello.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Maffione, A.M., Piva, M., Tsamita, C.S. et al. Positron-emission tomography in gynaecologic malignancies. Arch Gynecol Obstet 280, 521–528 (2009). https://doi.org/10.1007/s00404-009-0979-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-009-0979-2

Keywords

Search

Navigation