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18F-FDG PET in stage IB/IIB cervical adenocarcinoma/adenosquamous carcinoma

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The diagnostic and prognostic value of 18F-FDG PET in cervical adenocarcinoma/adenosquamous carcinoma (AC/ASC) is unclear. The aim of this study was to assess the value of PET in the management of cervical AC/ASC.

Methods

Patients with resectable FIGO stage IB/IIB cervical AC/ASC receiving a preoperative MRI scan and a PET or PET/CT scan before radical surgery were eligible. Diagnostic efficacy was compared by receiver operating characteristic (ROC) analysis. Correlations between clinicopathological parameters and outcome and maximum standardized uptake values (SUVmax) of FDG uptake were evaluated.

Results

The study group comprised 83 patients (mean age 48.3±9.7 years) Five-year overall survival was 85.5%, with a median follow-up time of 38.6 months (range 2.8–87.2 months). Pelvic lymph node (PLN) and paraaortic lymph node (PALN) metastases were seen in 32.5% and 8.4% of patients, respectively. The difference in diagnostic efficacy in identifying metastatic PALN between PET and MRI was significant (PET versus MRI, area under the curve 0.832 versus 0.607, p=0.039). SUVmax in primary tumour was correlated with LN metastasis and deep stromal invasion. Overall survival was significantly related to FIGO stage, PLN metastasis, deep cervical stromal invasion, tumour size measured by MRI, and SUVmax of the primary cervical tumour.

Conclusion

PET provided significantly better diagnostic efficacy than MRI in detecting PALN metastasis. Poor prognostic factors in cervical AC/ASC were SUVmax of the primary cervical tumour >5.3, stage IIB, deep cervical stromal invasion, tumour size measured by MRI ≥40 mm, and PLN metastasis.

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Acknowledgment

This study was supported by grants CMRPG-340011-12, CMRPG32022, and CMRPG-340052 from the Chang Gung Memorial Hospital at Linko.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Chang Gung Memorial Hospital and Chang Gung University, 5 Fu-Shin St. Kueishan, Taoyuan, 333, Taiwan

    Hung-Hsueh Chou, Chyong-Huey Lai, Tzu-I Wu, Ming-Yu Chen & Ting-Chang Chang

  2. Department of Nuclear Medicine, Chang Gung Memorial Hospital and Chang Gung University, 5 Fu-Shin St. Kueishan, Taoyuan, 333, Taiwan

    Hsiu-Ping Chang & Tzu-Chen Yen

  3. Department of Diagnostic Radiology, Chang Gung Memorial Hospital and Chang Gung University, 5 Fu-Shin St. Kueishan, Taoyuan, 333, Taiwan

    Koon-Kwan Ng

  4. Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University, 5 Fu-Shin St. Kueishan, Taoyuan, 333, Taiwan

    Swei Hsueh

  5. Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, 5 Fu-Shin St. Kueishan, Taoyuan, 333, Taiwan

    Ji-Hong Hong

Authors
  1. Hung-Hsueh Chou
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  2. Hsiu-Ping Chang
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  3. Chyong-Huey Lai
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  8. Tzu-Chen Yen
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  9. Ji-Hong Hong
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  10. Ting-Chang Chang
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Corresponding author

Correspondence to Ting-Chang Chang.

Additional information

Hung-Hsueh Chou and Hsiu-Ping Chang contributed equally to this work.

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Chou, HH., Chang, HP., Lai, CH. et al. 18F-FDG PET in stage IB/IIB cervical adenocarcinoma/adenosquamous carcinoma. Eur J Nucl Med Mol Imaging 37, 728–735 (2010). https://doi.org/10.1007/s00259-009-1336-1

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  • DOI: https://doi.org/10.1007/s00259-009-1336-1

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