Skip to main content
SpringerLink
Log in

Gynäkologische Tumoren

  • Chapter
  • First Online:
PET/CT-Atlas

  • 288 Accesses

Zusammenfassung

Gynäkologische Tumoren werden im Allgemeinen bei diesbezüglichen Untersuchungen entdeckt. Die PET/CT spielt in der Primärdiagnostik eine untergeordnete Rolle, in der Ausbreitungsdiagnostik überzeugt sie hingegen mit hohen negativ-prädiktiven Werten im Lymphknotenstaging. Dennoch ist sie in der aktuellen Leitlinie unterrepräsentiert und in der klinischen Routine (noch) nicht angekommen. Die Kosten für eine PET/CT im GKV-Bereich werden nur für das Ovarialkarzinom im Rahmen der ASV und auch hier nur sehr eingeschränkt übernommen. Aufgrund der guten Ergebnisse im Lymphknotenstaging sowie der sonstigen Ausbreitungsdiagnostik besteht jedoch das Potenzial für eine Einsatzerweiterung bei diesen Krankheitsbildern.

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

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Literatur

  1. Zentrum für Krebsregisterdaten und Gesellschaft der epidemiologischen Krebsregister in Deutschland e.V., Robert Koch-Institut Krebs in Deutschland für 2017/2018. https://www.krebsdaten.de/Krebs/DE/Content/Publikationen/Krebs_in_Deutschland/kid_2021/krebs_in_deutschland_2021.pdf. Zugegriffen: 3. Dez. 2021

  2. Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF): S3-Leitlinie Diagnostik, Therapie und Nachsorge maligner Ovarialtumoren, Langversion 5.0, 2021, AWMF-Registernummer: 032/035OL, https://www.leitlinienprogramm-onkologie.de/leitlinien/ovarialkarzinom/ (abgerufen am: 20. Jan. 2022)

  3. Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF): S3-Leitlinie Diagnostik, Therapie und Nachsorge der Patientin mit Zervixkarzinom, Langversion, 2.1, 2021, AWMF-Registernummer: 032/033OL, https://www.leitlinienprogramm-onkologie.de/leitlinien/zervixkarzinom/ (abgerufen am: 20. Jan. 2022)

  4. Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF): Diagnostik, Therapie und Nachsorge der Patientinnen mit Endometriumkarzinom, Langversion 1.0, 2018, AWMF Registernummer: 032/034-OL, http://www.leitlinienprogramm-onkologie.de/leitlinien/endometriumkarzinom/ (abgerufen am: 20. Jan. 2022)

  5. Yuan S, Yu Y, Chao KS, Fu Z, Yin Y, Liu T, Chen S, Yang X, Yang G, Guo H, Yu J (2006) Additional value of PET/CT over PET in assessment of locoregional lymph nodes in thoracic esophageal squamous cell cancer. J Nucl Med 47(8):1255–1259

    PubMed  Google Scholar 

  6. Hillner BE, Siegel BA, Liu D et al (2008) Impact of positron emission tomography/computed tomography and positron emission tomography (PET) alone on expected management of patients with cancer: initial results from the national oncologic PET registry. J Clin Oncol 26(13):2155–2161

    Article  PubMed  Google Scholar 

  7. Ebina Y, Watari H, Kaneuchi M, Takeda M, Hosaka M, Kudo M, Yamada H, Sakuragi N (2014) Impact of FDG PET in optimizing patient selection for cytoreductive surgery in recurrent ovarian cancer. Eur J Nucl Med Mol Imaging 41(3):446–451

    Article  CAS  PubMed  Google Scholar 

  8. Grigsby PW, Siegel BA, Dehdashti F, Rader J, Zoberi I (2004) Posttherapy [18F] fluorodeoxyglucose positron emission tomography in carcinoma of the cervix: response and outcome. J Clin Oncol 22(11):2167–2171

    Article  PubMed  Google Scholar 

  9. Havrilesky LJ, Kulasingam SL, Matchar DB, Myers ER (2005) FDG-PET for management of cervical and ovarian cancer. Gynecol Oncol 97(1):183–191

    Article  PubMed  Google Scholar 

  10. Zhu Y, Shen B, Pei X, Liu H, Li G (2021) CT, MRI, and PET imaging features in cervical cancer staging and lymph node metastasis. Am J Transl Res 13(9):10536–10544

    CAS  PubMed  PubMed Central  Google Scholar 

  11. Kitajima K, Suenaga Y, Ueno Y et al (2013) Value of fusion of PET and MRI for staging of endometrial cancer: comparison with 18F-FDG contrast-enhanced PET/CT and dynamic contrast-enhanced pelvic MRI. Eur J Radiol 82(10):1672–1676. https://doi.org/10.1016/j.ejrad.2013.05.005

    Article  PubMed  Google Scholar 

  12. Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF): Diagnostik, Therapie und Nachsorge der Patientinnen mit Endometriumkarzinom, Langversion 1.0, 2018, AWMF Registernummer: 032/034-OL, http://www.leitlinienprogramm-onkologie.de/leitlinien/endometriumkarzinom/ (abgerufen am 14. Dez. 2021)

  13. Rockall AG, Barwick TD, Wilson W et al (2021) Diagnostic accuracy of FEC-PET/CT, FDG-PET/CT, and ion-weighted MRI in detection of nodal metastases in surgically treated endometrial and cervical carcinoma. Clin Cancer Res 27(23):6457–6466. https://doi.org/10.1158/1078-0432.CCR-21-1834

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Richtlinie ambulante spezialfachärztliche Versorgung § 116b SGB V: Jährliche Anpassung der Appendizes an den aktuellen Einheitlichen Bewertungsmaßstab und weitere Änderungen (Beschlussdatum: 18.03.21, Inkrafttreten: 7. Aug. 2021)

    Google Scholar 

  15. Roett MA, Evans P (2009) Ovarian cancer: an overview. Am Fam Physician 80(6):609–616

    PubMed  Google Scholar 

  16. Gu P, Pan LL, Wu SQ, Sun L, Huang G (2009) CA 125, PET alone, PET-CT, CT and MRI in diagnosing recurrent ovarian carcinoma: a systematic review and meta-analysis. Eur J Radiol 71(1):164–174

    Article  PubMed  Google Scholar 

  17. Khiewvan B, Torigian DA, Emamzadehfard S, Paydary K, Salavati A, Houshmand S et al (2017) An update on the role of PET/CT and PET/MRI in ovarian cancer. Eur J Nucl Med Mol Imaging 44(6):1079–1091

    Article  CAS  PubMed  Google Scholar 

  18. Nama V, Angelopoulos G, Twigg J, Murdoch JB, Bailey J, Lawrie TA (2018) Type II or type III radical hysterectomy compared to chemoradiotherapy as a primary intervention for stage IB2 cervical cancer. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD011478.pub2

    Article  PubMed  PubMed Central  Google Scholar 

  19. Landoni F, Maneo A, Colombo A, Placa F, Milani R, Perego P et al (1997) Randomised study of radical surgery versus radiotherapy for stage Ib-IIa cervical cancer. Lancet 350(9077):535–540

    Article  CAS  PubMed  Google Scholar 

  20. Liu X, Wang J, Hu K, Zhang F, Meng Q, Wang W et al (2020) Validation of the 2018 FIGO staging system of cervical cancer for stage III patients with a cohort from China. Cancer Manag Res 12:1405–1410

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Todo Y, Watari H (2016) Concurrent chemoradiotherapy for cervical cancer: background including evidence-based data, pitfalls of the data, limitation of treatment in certain groups. Chin J Cancer Res 28(2):221–227

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Berger T, Seppenwoolde Y, Potter R, Assenholt MS, Lindegaard JC, Nout RA et al (2019) Importance of technique, target selection, contouring, dose prescription, and dose-planning in external beam radiation therapy for cervical cancer: evolution of practice from EMBRACE-I to II. Int J Radiat Oncol Biol Phys 104(4):885–894

    Article  PubMed  Google Scholar 

  23. Dimopoulos JC, Petrow P, Tanderup K, Petric P, Berger D, Kirisits C et al (2012) Recommendations from Gynaecological (GYN) GEC-ESTRO Working Group (IV): Basic principles and parameters for MR imaging within the frame of image based adaptive cervix cancer brachytherapy. Radiother Oncol 103(1):113–122

    Article  PubMed  PubMed Central  Google Scholar 

  24. Tan LT, Potter R, Sturdza A, Fokdal L, Haie-Meder C, Schmid M et al (2019) Change in patterns of failure after image-guided Brachytherapy for cervical cancer: analysis from the retroEMBRACE study. Int J Radiat Oncol Biol Phys 104(4):895–902

    Article  PubMed  Google Scholar 

  25. Tan Mbbs Mrcp Frcr Md LT, Tanderup Ph DK, Kirisits Ph DC, de Leeuw Ph DA, Nout Md Ph DR, Duke Mbbs Frcr S, et al Image-guided Adaptive Radiotherapy in Cervical Cancer. Semin Radiat Oncol. 2019;29(3):284-98.

    Google Scholar 

  26. Mazeron R, Petit C, Rivin E, Limkin E, Dumas I, Maroun P et al (2016) 45 or 50 Gy, Which is the Optimal Radiotherapy Pelvic Dose in Locally Advanced Cervical Cancer in the Perspective of Reaching Magnetic Resonance Image-guided Adaptive Brachytherapy Planning Aims? Clin Oncol 28(3):171–177

    Article  CAS  Google Scholar 

  27. Adam JA, Arkies H, Hinnen K, Stalpers LJ, van Waesberghe JH, Stoker J et al (2018) 18F-FDG-PET/CT guided external beam radiotherapy volumes in inoperable uterine cervical cancer. Q J Nucl Med Mol Imaging 62(4):420–428

    Article  PubMed  Google Scholar 

  28. Sheu MH, Chang CY, Wang JH, Yen MS (2001) Preoperative staging of cervical carcinoma with MR imaging: a reappraisal of diagnostic accuracy and pitfalls. Eur Radiol 11(9):1828–1833

    Article  CAS  PubMed  Google Scholar 

  29. Signorelli M, Guerra L, Montanelli L, Crivellaro C, Buda A, Dell’Anna T et al (2011) Preoperative staging of cervical cancer: is 18-FDG-PET/CT really effective in patients with early stage disease? Gynecol Oncol 123(2):236–240

    Article  PubMed  Google Scholar 

  30. Rose PG, Adler LP, Rodriguez M, Faulhaber PF, Abdul-Karim FW, Miraldi F (1999) Positron emission tomography for evaluating para-aortic nodal metastasis in locally advanced cervical cancer before surgical staging: a surgicopathologic study. J Clin Oncol 17(1):41–45

    Article  CAS  PubMed  Google Scholar 

  31. Wright JD, Dehdashti F, Herzog TJ, Mutch DG, Huettner PC, Rader JS et al (2005) Preoperative lymph node staging of early-stage cervical carcinoma by [18F]-fluoro-2-deoxy-D-glucose-positron emission tomography. Cancer 104(11):2484–2491

    Article  PubMed  Google Scholar 

  32. Chou HH, Chang TC, Yen TC, Ng KK, Hsueh S, Ma SY et al (2006) Low value of [18F]-fluoro-2-deoxy-D-glucose positron emission tomography in primary staging of early-stage cervical cancer before radical hysterectomy. J Clin Oncol 24(1):123–128

    Article  PubMed  Google Scholar 

  33. Lv K, Guo HM, Lu YJ, Wu ZX, Zhang K, Han JK (2014) Role of 18F-FDG PET/CT in detecting pelvic lymph-node metastases in patients with early-stage uterine cervical cancer: comparison with MRI findings. Nucl Med Commun 35(12):1204–1211

    Article  CAS  PubMed  Google Scholar 

  34. Margulies AL, Peres A, Barranger E, Perreti I, Brouland JF, Toubet E et al (2013) Selection of patients with advanced-stage cervical cancer for para-aortic lymphadenectomy in the era of PET/CT. Anticancer Res 33(1):283–286

    PubMed  Google Scholar 

  35. Ramirez PT, Jhingran A, Macapinlac HA, Euscher ED, Munsell MF, Coleman RL et al (2011) Laparoscopic extraperitoneal para-aortic lymphadenectomy in locally advanced cervical cancer: a prospective correlation of surgical findings with positron emission tomography/computed tomography findings. Cancer 117(9):1928–1934

    Article  PubMed  Google Scholar 

  36. Leblanc E, Gauthier H, Querleu D, Ferron G, Zerdoud S, Morice P et al (2011) Accuracy of 18-fluoro-2-deoxy-D-glucose positron emission tomography in the pretherapeutic detection of occult para-aortic node involvement in patients with a locally advanced cervical carcinoma. Ann Surg Oncol 18(8):2302–2309

    Article  CAS  PubMed  Google Scholar 

  37. Gouy S, Morice P, Narducci F, Uzan C, Gilmore J, Kolesnikov-Gauthier H et al (2012) Nodal-staging surgery for locally advanced cervical cancer in the era of PET. Lancet Oncol 13(5):e212–e220

    Article  PubMed  Google Scholar 

  38. Frumovitz M, Ramirez PT, Macapinlac HA, Klopp AH, Nick AM, Ramondetta LM et al (2012) Anatomic location of PET-positive aortocaval nodes in patients with locally advanced cervical cancer: implications for surgical staging. Int J Gynecol Cancer 22(7):1203–1207

    Article  PubMed  PubMed Central  Google Scholar 

  39. Yu W, Kou C, Bai W, Yu X, Duan R, Zhu B et al (2019) The diagnostic performance of PET/CT scans for the detection of para-aortic metastatic lymph nodes in patients with cervical cancer: a meta-analysis. Plos One 14(7):e220080

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Kohler C, Mustea A, Marnitz S, Schneider A, Chiantera V, Ulrich U et al (2015) Perioperative morbidity and rate of upstaging after laparoscopic staging for patients with locally advanced cervical cancer: results of a prospective randomized trial. Am J Obstet Gynecol 213(4):503 e1–503 e7

    Article  PubMed  Google Scholar 

  41. Marnitz S, Schram J, Budach V, Sackerer I, Vercellino GF, Sehouli J et al (2015) Extended field chemoradiation for cervical cancer patients with histologically proven para-aortic lymph node metastases after laparaoscopic lymphadenectomy. Strahlenther Onkol 191(5):421–428

    Article  PubMed  Google Scholar 

  42. Marnitz S, Martus P, Köhler C, Stromberger C, Asse E, Mallmann P et al (2016) Role of Surgical Versus Clinical Staging in Chemoradiated FIGO Stage IIB-IVA Cervical Cancer Patients – Acute Toxicity and Treatment Quality of the Uterus-11 Multicenter Phase III Intergroup Trial of the German Radiation Oncology Group and the Gynecologic Cancer Group. Int J Radiat Oncol Biol Phys 94(2):243–253

    Article  PubMed  Google Scholar 

  43. Marnitz S, Kohler C, Roth C, Fuller J, Bischoff A, Wendt T et al (2007) Stage-adjusted chemoradiation in cervical cancer after transperitoneal laparoscopic staging. Strahlenther Onkol 183(9):473–478

    Article  PubMed  Google Scholar 

  44. Marnitz S, Kohler C, Affonso RJ, Schneider A, Chiantera V, Tsounoda A et al (2012) Validity of laparoscopic staging to avoid adjuvant chemoradiation following radical surgery in patients with early cervical cancer. Oncology 83(6):346–353

    Article  PubMed  Google Scholar 

  45. Marnitz S, Tsunoda AT, Martus P, Vieira M, Junior ARJ, Nunes J et al (2020) Surgical versus clinical staging prior to primary chemoradiation in patients with cervical cancer FIGO stages IIB-IVA: oncologic results of a prospective randomized international multicenter (Uterus-11) intergroup study. Int J Gynecol Cancer 30(12):1855–1861

    Article  PubMed  PubMed Central  Google Scholar 

  46. Tsunoda AT, Marnitz S, Soares Nunes J, Mattos de Cunha Andrade CE, Scapulatempo Neto C, Blohmer JU et al (2017) Incidence of histologically proven pelvic and para-aortic lymph node metastases and rate of upstaging in patients with locally advanced cervical cancer: results of a prospective randomized trial. Oncology 92(4):213–220

    Article  PubMed  Google Scholar 

  47. Choi HJ, Ju W, Myung SK, Kim Y (2010) Diagnostic performance of computer tomography, magnetic resonance imaging, and positron emission tomography or positron emission tomography/computer tomography for detection of metastatic lymph nodes in patients with cervical cancer: meta-analysis. Cancer Sci 101(6):1471–1479

    Article  CAS  PubMed  Google Scholar 

  48. Selman TJ, Mann C, Zamora J, Appleyard TL, Khan K (2008) Diagnostic accuracy of tests for lymph node status in primary cervical cancer: a systematic review and meta-analysis. CMAJ 178(7):855–862

    Article  PubMed  PubMed Central  Google Scholar 

  49. Mittra E, El-Maghraby T, Rodriguez CA, Quon A, McDougall IR, Gambhir SS et al (2009) Efficacy of 18F-FDG PET/CT in the evaluation of patients with recurrent cervical carcinoma. Eur J Nucl Med Mol Imaging 36(12):1952–1959

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Gee MS, Atri M, Bandos AI, Mannel RS, Gold MA, Lee SI (2018) Identification of distant metastatic disease in uterine cervical and Endometrial cancers with FDG PET/CT: analysis from the ACRIN 6671/GOG 0233 multicenter trial. Radiology 287(1):176–184

    Article  PubMed  Google Scholar 

  51. Scher N, Castelli J, Depeursinge A, Bourhis J, Prior JO, Herrera FG et al (2018) ((18)F)-FDG PET/CT parameters to predict survival and recurrence in patients with locally advanced cervical cancer treated with chemoradiotherapy. Cancer Radiother 22(3):229–235

    Article  CAS  PubMed  Google Scholar 

  52. Oh D, Lee JE, Huh SJ, Park W, Nam H, Choi JY et al (2013) Prognostic significance of tumor response as assessed by sequential 18F-fluorodeoxyglucose-positron emission tomography/computed tomography during concurrent chemoradiation therapy for cervical cancer. Int J Radiat Oncol Biol Phys 87(3):549–554

    Article  PubMed  Google Scholar 

  53. Ding XP, Feng L, Ma L (2014) Diagnosis of recurrent uterine cervical cancer: PET versus PET/CT: a systematic review and meta-analysis. Arch Gynecol Obstet 290(4):741–747

    Article  PubMed  Google Scholar 

  54. Yen TC, Lai CH, Ma SY, Huang KG, Huang HJ, Hong JH et al (2006) Comparative benefits and limitations of 18F-FDG PET and CT-MRI in documented or suspected recurrent cervical cancer. Eur J Nucl Med Mol Imaging 33(12):1399–1407

    Article  PubMed  Google Scholar 

  55. Triumbari EKA, de Koster EJ, Rufini V, Fragomeni SM, Garganese G, Collarino A (2021) 18F-FDG PET and 18F-FDG PET/CT in vulvar cancer: a systematic review and meta-analysis. Clin Nucl Med 46(2):125–132

    Article  PubMed  Google Scholar 

  56. Chang MC, Chen JH, Liang JA, Yang KT, Cheng KY, Kao CH (2012) 18F-FDG PET or PET/CT for detection of metastatic lymph nodes in patients with endometrial cancer: a systematic review and meta-analysis. Eur J Radiol 81(11):3511–3517

    Article  PubMed  Google Scholar 

  57. Antonsen SL, Jensen LN, Loft A, Berthelsen AK, Costa J, Tabor A et al (2013) MRI, PET/CT and ultrasound in the preoperative staging of endometrial cancer – a multicenter prospective comparative study. Gynecol Oncol 128(2):300–308

    Article  CAS  PubMed  Google Scholar 

  58. Vrede SW, van Weelden WJ, Visser NCM, Bulten J, van der Putten LJM, van de Vijver K et al (2021) Immunohistochemical biomarkers are prognostic relevant in addition to the ESMO-ESGO-ESTRO risk classification in endometrial cancer. Gynecol Oncol 161(3):787–794

    Article  CAS  PubMed  Google Scholar 

  59. Concin N, Matias-Guiu X, Vergote I, Cibula D, Mirza MR, Marnitz S et al (2021) ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma. Int J Gynecol Cancer 31(1):12–39

    Article  PubMed  Google Scholar 

  60. Lerman H, Metser U, Grisaru D et al (2004) Normal and abnormal 18F-FDG endometrial and ovarian uptake in pre-and postmenopausal patients: assessment by PET/CT. J Nucl Med 45:266–271

    PubMed  Google Scholar 

Weiterführende Literatur

  1. Chung HH, Kang WJ, Kim JW, Park NH, Song YS, Chung JK et al (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(6):1081–1088

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Diagnostisch Therapeutisches Zentrum, Berlin, Deutschland

    Prof. Dr. med. Wolfgang Mohnike

  2. Klinik und Poliklinik für Radioonkologie, Cyberknife- und Strahlentherapie, Universitätsklinikum Köln (AöR), Köln, Deutschland

    Dr. med. Simone Wegen

  3. Schwerpunkt Gynäkologische Onkologie, IZD – Institut für Zytologie und Dysplasie Köpenick-Zweigpraxis GVZ Kreuzberg, Berlin, Deutschland

    Dr. med. Christopher Koßagk

Authors
  1. Prof. Dr. med. Wolfgang Mohnike
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Dr. med. Simone Wegen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dr. med. Christopher Koßagk
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Wolfgang Mohnike .

Editor information

Editors and Affiliations

  1. DTZ, Diagnostic and Treatment Centre Berlin, Berlin, Deutschland

    Wolfgang Mohnike

  2. DTZ, Diagnostic and Treatment Centre Berlin, Berlin, Deutschland

    Konrad Mohnike

  3. DTZ, Diagnostic and Treatment Centre Berlin, Berlin, Berlin, Deutschland

    Matthias Lampe

Rights and permissions

Reprints and permissions

Copyright information

© 2024 Der/die Autor(en), exklusiv lizenziert an Springer-Verlag GmbH, DE, ein Teil von Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Mohnike, W., Wegen, S., Koßagk, C. (2024). Gynäkologische Tumoren. In: Mohnike, W., Mohnike, K., Lampe, M. (eds) PET/CT-Atlas. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-67192-4_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-67192-4_9

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-67191-7

  • Online ISBN: 978-3-662-67192-4

  • eBook Packages: Medicine (German Language)

Publish with us

Policies and ethics

Search

Navigation