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Nuklearmedizin 2019; 58(01): 17-22
DOI: 10.1055/a-0809-4577
Original Article
© Georg Thieme Verlag KG Stuttgart · New York

Influence of 18F-FDG-PET/CT on staging of cervical cancer

Einfluss des 18F-FDG PET/CT auf den Behandlungsverlauf von Gebärmutterhalskrebs
Paulina Cegla
1   Nuclear Medicine Department, Greater Poland Cancer Centre, Poznan
,
Bartosz Urbanski
2   Department of Radiotherapy and Oncological Gynaecology, Greater Poland Cancer Centre, Poznan
,
Ewa Burchardt
2   Department of Radiotherapy and Oncological Gynaecology, Greater Poland Cancer Centre, Poznan
,
Andrzej Roszak
3   Chair and Department of Electroradiology, Poznan University of Medical Science, Poznan
2   Department of Radiotherapy and Oncological Gynaecology, Greater Poland Cancer Centre, Poznan
,
Witold Cholewinski
3   Chair and Department of Electroradiology, Poznan University of Medical Science, Poznan
1   Nuclear Medicine Department, Greater Poland Cancer Centre, Poznan
› Author Affiliations
Further Information

Publication History

07/30/2018

11/27/2018

Publication Date:
15 February 2019 (online)

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Abstract

Aim Cervical cancer is one of the most common cancers of the female reproductive system. The aim of the study was to assess the usefulness of the 18F-FDG-PET/CT study in staging of cervical cancer, with focus on the primary tumor parameters.

Material & Methods 105 patients (mean age 56 ± 11y) with newly diagnosed cervical cancer underwent PET/CT examination which was performed 60 min after IV injection of 18F-FDG with a mean activity of 364 ± 75MBq. 68 patients were diagnosed with stage IIIA/IIIB, 19 patients with IIB, 10 patients with IB, 8 patients with stage IVA/IVB. Wilcoxon-Mann-Whitney test and ROC curves were used for statistical analysis.

Results In 35 cases 18F-FDG-PET/CT did not show active proliferative process outside the cervix. In 38 cases metastases were found in iliac lymph nodes and in 32 patients scans showed metastases above the aortic bifurcation including lymph nodes and other organs. The largest volumes of primary tumor occurred in patients with distant metastases, while the lowest in patients with disease limited only to cervix. In 63 % of the patients PET/CT result was compatible with FIGO classification, in 20 % patients PET/CT result showed less advanced disease and in 17 % of the patients PET/CT results were higher than FIGO classification.

Conclusion PET/CT using 18F-FDG has an important impact on the assessment of the stage of cervical cancer. In over 30 % of patients, this study resulted in a radical change in the treatment plan.

Zusammenfassung

Ziel Gebärmutterhalskrebs ist einer der häufigsten Krebsarten des weibliche Fortpflanzungssystems. Ziel der vorliegenden Studie war es, die folgenden Punkte zu berücksichtigen: Bewertung des Nutzens eines 18F-FDG-PET/CTs beim Staging von Gebärmutterhalskrebs, mit Fokus auf die primären Tumorparameter.

Material & Methoden 105 Patienten (Durchschnittsalter 56 ± 11 Jahre) mit neu diagnostiziertem Gebärmutterhalskrebs wurden 60 min i.v. einer 18F-FDG-PET/CT-Untersuchung unterzogen (mittlere Aktivität 364 ± 75 MBq). 68 Patienten aus Stadium IIIA/IIIB, 19 Patienten mit IIB, 10 Patienten mit IB, 8 Patienten mit Stadium IVA/IVB. Wilcoxon-Mann-Whitney-Test und ROC-Kurven wurden für die statistische Analyse verwendet.

Ergebnisse In 35 Fällen zeigte 18F-FDG-PET/CT keine aktiven Proliferationsprozesse außerhalb des Gebärmutterhalses. In 38 Fällen wurden Metastasen in den Lymphknoten des Beckens gefunden und bei 32 Patienten zeigten Scans Metastasen über der Aortengabelung einschließlich der Lymphknoten und anderer Organe. Die größten Volumina des Primärtumors konnten bei Patienten mit Fernmetastasen, während der niedrigste Wert für die bei Patienten mit einer Erkrankung, die sich nur auf den Gebärmutterhals beschränkt beobachtet wurde. In 63 % der Fälle waren die PET/CT-Ergebnisse mit der FIGO-Klassifizierung kompatibel, bei 20 % zeigten PET/CT-Ergebnisse weniger fortgeschrittene Erkrankungen und bei 17 % der Patienten waren die PET/CT-Ergebnisse höher als die der FIGO-Klassifizierung.

Schlussfolgerung PET/CT mit 18F-FDG hat einen wichtigen Einfluss auf die Beurteilung des Stadiums von Gebärmutterhals krebs. In über 30 % der Fälle führten die erhaltenen Ergebnisse zu einer radikalen Veränderung des Behandlungsplans.

Key words

cervical cancer - 18F-FDG-PET/CT - treatment planning - staging - FIGO

Schlüsselwörter

Gebärmutterhalskrebs - 18F-FDG-PET/CT - Therapieplanung - Tumorklassifikation - FIGO
 

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