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

Hung Hsueh Chou, Hsiu Ping Chang, Chyong Huey Lai, Koon Kwan Ng, Swei Hsueh, Tzu I. Wu, Ming Yu Chen, Tzu Chen Yen, Ji Hong Hong, Ting Chang Chang

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29 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)728-735
Number of pages8
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume37
Issue number4
DOIs
Publication statusPublished - Apr 2010
Externally publishedYes

Keywords

  • Cervical adenocarcinoma
  • FDG PET
  • Prognostic factors
  • Standardized uptake value

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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    Chou, H. H., Chang, H. P., Lai, C. H., Ng, K. K., Hsueh, S., Wu, T. I., Chen, M. Y., Yen, T. C., Hong, J. H., & Chang, T. C. (2010). 18F-FDG PET in stage IB/IIB cervical adenocarcinoma/ adenosquamous carcinoma. European Journal of Nuclear Medicine and Molecular Imaging, 37(4), 728-735. https://doi.org/10.1007/s00259-009-1336-1