<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec id="j_raon-2022-0042_s_006">
<h3>Background</h3>
<p>Recurrent disease in post-irradiation patients with cervical cancer is often difficult to delineate on magnetic resonance imaging (MRI), because posttreatment changes can have a similar appearance, and further evaluation is often required. The aims of the study were to evaluate positron emission tomography/computed tomography with 18F-fluorodeoxyglucose (FDG PET-CT) diagnostic role in suspected recurrent cervical cancer after radiotherapy, compare it to MRI, and assess their prognostic impact in these patients.</p>
</sec>
<sec id="j_raon-2022-0042_s_007">
<h3>Patients and methods</h3>
<p>This cohort retrospective study included patients previously treated with radiotherapy for carcinoma of uterine cervix with suspected recurrence, who had undergone MRI of abdomen and pelvis, and were subsequently evaluated on FDG PET-CT, with minimum follow-up period of 12 months.</p>
</sec>
<sec id="j_raon-2022-0042_s_008">
<h3>Results</h3>
<p>In the total of 84 patients included in analysis, MRI <italic>vs</italic>. FDG PET-CT showed sensitivity, specificity and accuracy of 80.1%, 52.4% and 66.7%, <italic>vs</italic>. 97.6%, 61.9% and 79.8%, respectively. Patients with positive findings on MRI (Log Rank, p = 0.003) and PET-CT (Log Rank, p &lt; 0.001) had shorter progression-free survival (PFS) than those with negative results. In univariate Cox regression models, MRI and FDG PET-CT results were found to be related to PFS (p = 0.005 and p &lt; 0.001, respectively). However, multivariate analysis proved only FDG PET-CT to be independent prognostic factor, where patients with positive FDG PET-CT results had almost nine times higher risk of progression (p &lt; 0.001).</p>
</sec>
<sec id="j_raon-2022-0042_s_009">
<h3>Conclusion</h3>
<p>FDG PET-CT represents useful diagnostic tool in suspected recurrent cervical cancer after radiotherapy, showing high sensitivity in its detection. In addition, it is an independent factor in predicting progression-free survival in these patients.</p>
</sec>
</abstract>

Background
Recurrent disease in post-irradiation patients with cervical cancer is often difficult to delineate on magnetic resonance imaging (MRI), because posttreatment changes can have a similar appearance, and further evaluation is often required. The aims of the study were to evaluate positron emission tomography/computed tomography with 18F-fluorodeoxyglucose (FDG PET-CT) diagnostic role in suspected recurrent cervical cancer after radiotherapy, compare it to MRI, and assess their prognostic impact in these patients.


Patients and methods
This cohort retrospective study included patients previously treated with radiotherapy for carcinoma of uterine cervix with suspected recurrence, who had undergone MRI of abdomen and pelvis, and were subsequently evaluated on FDG PET-CT, with minimum follow-up period of 12 months.


Results
In the total of 84 patients included in analysis, MRI vs. FDG PET-CT showed sensitivity, specificity and accuracy of 80.1%, 52.4% and 66.7%, vs. 97.6%, 61.9% and 79.8%, respectively. Patients with positive findings on MRI (Log Rank, p = 0.003) and PET-CT (Log Rank, p < 0.001) had shorter progression-free survival (PFS) than those with negative results. In univariate Cox regression models, MRI and FDG PET-CT results were found to be related to PFS (p = 0.005 and p < 0.001, respectively). However, multivariate analysis proved only FDG PET-CT to be independent prognostic factor, where patients with positive FDG PET-CT results had almost nine times higher risk of progression (p < 0.001).


Conclusion
FDG PET-CT represents useful diagnostic tool in suspected recurrent cervical cancer after radiotherapy, showing high sensitivity in its detection. In addition, it is an independent factor in predicting progression-free survival in these patients.

FDG PET-CT as an important diagnostic tool and prognostic marker in suspected recurrent cervical carcinoma after radiotherapy: comparison with MRI

Radiology and Oncology

This work is licensed under the Creative Commons Attribution 4.0 International License.

Background
Recurrent disease in post-irradiation patients with cervical cancer is often difficult to delineate on magnetic resonance imaging (MRI), because...

FDG PET-CT as an important diagnostic tool and prognostic marker in suspected recurrent cervical carcinoma after radiotherapy: comparison with MRI

Article Category: Research Article

Publicado en línea: 02 nov 2022

Páginas: 453 - 460

Recibido: 18 abr 2022

Aceptado: 15 sept 2022

DOI: https://doi.org/10.2478/raon-2022-0042

© 2022 Milica Stojiljkovic, Dragana Sobic Saranovic, Strahinja Odalovic, Marina Popovic, Jelena Petrovic, Nevena Rankovic, Milos Veljkovic, Vera Artiko, published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.