18F-FDG PET in the management of endometrial cancer

Angel Chao, Ting Chang Chang, Koon Kwan Ng, Swei Hsueh, Huei Jean Huang, Hung Hsueh Chou, Chien Sheng Tsai, Tzu Chen Yen, Tzu I. Wu, Chyong Huey Lai

Research output: Contribution to journalArticlepeer-review

76 Citations (Scopus)

Abstract

Purpose: Few studies have investigated the clinical impact of whole-body positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) in endometrial cancer. We aimed to assess the value of integrating FDG-PET into the management of endometrial cancer in comparison with conventional imaging alone. Methods: All patients with histologically confirmed primary advanced (stage III/IV) or suspicious/documented recurrent endometrial cancer, with poor prognostic features (serum CA-125 >35 U/ml or unfavourable cell types), or surveillance after salvage therapy were eligible. Before FDG-PET scanning, each patient had received magnetic resonance imaging and/or computed tomography (MRI-CT). The receiver operating characteristic curve method with calculation of the area under the curve (AUC) was used to compare the diagnostic efficacy. Clinical impacts were determined on a scan basis. Results: Forty-nine eligible patients were accrued and 60 studies were performed (27 primary staging, 33 post-therapy surveillance or restaging on relapse). The clinical impact was positive in 29 (48.3%) of the 60 scans. Mean standardised uptake values (SUVs) of true-positive lesions were 13.2 (range 5.7-37.4) for central pelvic lesions and 11.1 (range 1.5-37.4) for metastases. The sensitivity of FDG-PET alone (P<0.0001) or FDG-PET plus MRI-CT (P<0.0001) was significantly higher than that of MRI-CT alone in overall lesion detection. FDG-PET plus MRI-CT was significantly superior to MRI-CT alone in overall lesion detection (AUC 0.949 vs 0.872; P=0.004), detection of pelvic nodal/soft tissue metastases (P=0.048) and detection of extrapelvic metastases (P=0.010), while FDG-PET alone was only marginally superior by AUC (P=0.063). Conclusion: Whole-body FDG-PET coupled with MRI-CT facilitated optimal management of endometrial cancer in well-selected cases.

Original languageEnglish
Pages (from-to)36-44
Number of pages9
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume33
Issue number1
DOIs
Publication statusPublished - Jan 2006
Externally publishedYes

Keywords

  • Endometrial cancer
  • F-FDG PET
  • Primary staging
  • Recurrence
  • Salvage therapy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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