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

Milica Stojiljkovic
Milica Stojiljkovic
, 
Dragana Sobic Saranovic
Dragana Sobic Saranovic
, 
Strahinja Odalovic
Strahinja Odalovic
, 
Marina Popovic
Marina Popovic
, 
Jelena Petrovic
Jelena Petrovic
, 
Nevena Rankovic
Nevena Rankovic
, 
Milos Veljkovic
Milos Veljkovic
 e 
Vera Artiko
Vera Artiko
   | 02 nov 2022
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Article Category: Research Article
Pubblicato online: 02 nov 2022
Pagine: 453 - 460
Ricevuto: 18 apr 2022
Accettato: 15 set 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.

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.
eISSN:
1581-3207
Lingua:
Inglese
Frequenza di pubblicazione:
4 volte all'anno
Argomenti della rivista:
Medicine, Clinical Medicine, Internal Medicine, Haematology, Oncology, Radiology
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