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Restaging of recurrent cervical carcinoma with dual-phase [18F]fluoro-2-deoxy-D-glucose positron emission tomography
Version of Record online: 18 DEC 2003
Copyright © 2003 American Cancer Society
Volume 100, Issue 3, pages 544–552, 1 February 2004
How to Cite
Lai, C.-H., Huang, K.-G., See, L.-C., Yen, T.-C., Tsai, C.-S., Chang, T.-C., Chou, H.-H., Ng, K.-K., Hsueh, S. and Hong, J.-H. (2004), Restaging of recurrent cervical carcinoma with dual-phase [18F]fluoro-2-deoxy-D-glucose positron emission tomography. Cancer, 100: 544–552. doi: 10.1002/cncr.11928
- Issue online: 20 JAN 2004
- Version of Record online: 18 DEC 2003
- Manuscript Accepted: 20 OCT 2003
- Manuscript Revised: 16 OCT 2003
- Manuscript Received: 26 SEP 2003
- National Science Council of Taiwan. Grant Number: NSC 91-2314-B-182A-163
- Institute of Nuclear Energy Research and the National Science Council of Taiwan. Grant Number: NSC 92-NU-182A-003
- Chang Gung Memorial Hospital. Grant Number: CTRP-018
- recurrent cervical carcinoma;
- positron emission tomography;
The clinical value of positron emission tomography (PET) with [18F]fluoro-2-deoxy-D-glucose (FDG) for primary staging in cervical carcinoma appears to be promising. The authors sought to evaluate the diagnostic efficacy and benefit of PET in restaging cervical carcinoma at the time of first recurrence.
Forty patients with cervical carcinoma who experienced confirmed treatment failure but who were feasible candidates for curative salvage therapy were enrolled prospectively in the current study. Restaging was performed with PET and with computed tomography and/or magnetic resonance imaging (CT/MRI). Dual-phase PET was performed by adding 3-hour-delayed images to the 40-minute scans. The results of the PET and CT/MRI scans were compared. Lesion status was determined by pathologic findings or by clinical follow-up. The receiver operating characteristic curve method with calculation of area under the curve (AUC) was used to evaluate diagnostic efficacy. The primary endpoint was percent improvement in restaging (with improvement indicated by treatment modification) after PET. The secondary endpoint was 2-year overall survival among study participants compared with comparable previously treated patients who did not undergo disease restaging with PET.
Twenty-two patients (55%) had their treatment modified due to PET findings. PET was significantly superior to CT/MRI (sensitivity: 92% vs. 60%; AUC: 0.962 vs. 0.771; P < 0.0001) in identifying metastatic lesions. For individuals receiving primary surgery, a significantly better 2-year overall survival rate was observed among study participants compared with patients who underwent disease restaging without PET (HR, 0.21 [95% confidence interval, 0.05–0.83]; P = 0.020).
Dual-phase FDG-PET is superior to CT/MRI in the restaging of recurrent cervical carcinoma. Restaging with PET provides benefit by allowing the physician to offer optimal management of recurrent cervical carcinoma. Cancer 2004. © 2003 American Cancer Society.