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18F-FDG PET in the management of endometrial cancer

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

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.

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Acknowledgements

This study was supported by grant CMRPG32022 from Chang Gung Memorial Hospital and grant NSC-93-NU-7-182-003 from the National Science Council and the Institute of Nuclear Energy Research, Taiwan.

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Authors and Affiliations

  1. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

    Angel Chao, Ting-Chang Chang, Huei-Jean Huang, Hung-Hsueh Chou, Tzu-I Wu & Chyong-Huey Lai

  2. Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan

    Angel Chao

  3. Department of Radiology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

    Koon-Kwan Ng

  4. Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

    Swei Hsueh

  5. Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

    Chien-Sheng Tsai

  6. Department of Nuclear Medicine, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

    Tzu-Chen Yen

  7. Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital Linkou Medical Center, 5 Fu-Shin Street, Kueishan, Taoyuan, 333, Taiwan

    Chyong-Huey Lai

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  1. Angel Chao
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Correspondence to Chyong-Huey Lai.

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Chao, A., Chang, TC., Ng, KK. et al. 18F-FDG PET in the management of endometrial cancer. Eur J Nucl Med Mol Imaging 33, 36–44 (2006). https://doi.org/10.1007/s00259-005-1876-y

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  • DOI: https://doi.org/10.1007/s00259-005-1876-y

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