摘要
Purpose. We evaluated the use of positron emission tomography (PET) with fluorine- 18- labeled fluoro- 2- deoxy- d- glucose (FDG) in follow- up study after radiation therapy in patients with uterine cervical carcinoma. Materials and methods. Thirty- two studies in 25 patients were reviewed. Twenty patients were treated with external beam irradiation and intracavitary brachytherapy, and five with irradiation following initial surgery. Time frominitial treatment to FDG- PET was 23.3 (5.2- 88.0) months. Rationale for FDG- PET was the presence of symptoms in 6 patients, abnormal serum tumor marker values in 13, abnormal lesions on other diagnostic imaging modalities in 19, and patient request in 2. On visualization of a lesion, the maximum standardized uptake value (maxSUV) of the lesion was calculated, and values over 2.0 were classified as FDG- positive. Maximum tumor diameter and tumor volume in the corresponding disease were estimated by computed tomography (CT) or magnetic resonance imaging (MRI). Results. Sensitivity and specificity of FDG- PET in the detection of recurrent disease were 91.5% (43/47) and 57.1% (4/7), respectively. Four false negative findings were seen for small lung metastases having a volume less than 1 cm3. Three false- positive cases were a localized pneumonitis, a benign pubic bone fracture,and a fibrosis after interstitial brachytherapy. Sensitivity for extrapelvic lymph node metastases was extremely high (100% ); in contrast, sensitivity and specificity for lung and bone lesions were 75.0% (12/16) and 33.3% (1/3), respectively. Regarding tumor volume measurement, good correlation between maxSUV on FDG- PET and tumor volume was obtained (lung metastases, P = 0.03; extrapelvic nodes, P < 0.0001). Within this study, all corresponding lesions over 1 cm3 showed a maxSUV value greater than 2.0. Conclusion. FDG- PET is a useful tool for the detection of extrapelvic lesions during the follow- up period after radiation therapy for cervical cancer. This study suggests that FDG uptake is associated with tumor volume, and FDG- PET has limitations in the detection of lesions less than 1 cm3 or microscopic disease. Careful diagnostic agreement between PET and CT/MRI for positive but benign lesions, such as inflammation and bone fracture, remains important.
Purpose. We evaluated the use of positron emission tomography （PET） with fluorine - 18 - labeled fluoro - 2-deoxy-d - glucose （FDG） in follow-up study after radiation therapy in patients with uterine cervical carcinoma. Materials and methods. Thirty-two studies in 25 patients were reviewed. Twenty patients were treated with external beam irradiation and intracavitary brachytherapy, and five with irradiation following initial surgery. Time frominitial treatment to FDG-PET was 23.3 （5.2-88.0） months. Rationale for FDG - PET was the presence of symptoms in 6 patients, abnormal serum tumor marker values in 13, abnormal lesions on other diagnostic imaging modalities in 19, and patient request in 2. On visualization of a lesion, the maximum standardized uptake value （maxSUV） of the lesion was calculated, and values over 2.0 were classified as FDG-positive. Maximum tumor diameter and tumor volume in the corresponding disease were estimated by computed tomography （CT） or magnetic resonance imaging （MRI）.
