Andrei Iagaru MD, Presenter: Nothing to Disclose

Cesar Rodriguez MD, Abstract Co-Author: Nothing to Disclose

Tarek El-Maghraby, Abstract Co-Author: Nothing to Disclose

Andrew Quon MD, Abstract Co-Author: Research grant, Genentech, Inc

Sanjiv Sam Gambhir MD, PhD, Abstract Co-Author: Board of Directors, Lumera Corporation Stockholder, Lumera Corporation Stockholder, Pfizer Inc Consultant, Spectrum Dynamics Ltd Stockholder, Spectrum Dynamics Ltd Grant, Johnson & Johnson (ALZA Corporation) Committee member, Amgen Inc Scientific Advisory Board, Novartis AG (Chiron) Scientific Advisory Board, Siemens AG (PETNET Solutions) Royalties, Reed Elsevier Scientific Advisory Board, Genentech, Inc Scientific Advisory Board, General Electric Company Grant, General Electric Company (Amersham plc) Research collaboration, GlaxoSmithKline plc Scientific Advisory Board, GlaxoSmithKline plc Scientific Advisory Board, Intronn Inc Research collaboration, Intronn Inc Grant, Intronn Inc Scientific Advisory Board, Lumen Therapeutics Consultant, MediGene AG Scientific Advisory Board, MediGene AG Consultant, Millennium Pharmaceuticals, Inc Research collaboration, Pfizer Inc Grant, Pfizer Inc Consultant, Koninklijke Philips Electronics NV Scientific Advisory Board, Koninklijke Philips Electronics NV Consultant, Pathwork Diagnostics (Predicant Biosciences) Grant, Bayer AG Speaker, Siemens AG Scientific Advisory Board, Varian Medical Systems, Inc Scientific Advisory Board, VisualSonics Inc

Ross McDougall MD, Abstract Co-Author: Nothing to Disclose

18F FDG PET/CT is becoming widely available as a powerful imaging modality, combining the ability to detect active metabolic processes and their morphologic features in a single exam. The role of 18F FDG PET was studied in a variety of cancers, including cervical carcinoma, but its sensitivity and specificity calculations are based on dedicated PET acquisitions, not PET/CT in the majority of the published studies. Therefore, we were prompted to review our experience with PET/CT in the management of patients with cervical carcinoma.

This is a retrospective study of 30 women with cervical carcinoma, 28-87 years old (average: 49.6 ± 15.7), who had whole-body PET/CT at our institution from Jan 1st, 2003 to Aug 31st, 2006. Reinterpretation of the imaging studies for accuracy and data analysis from medical records were performed. Sensitivity and specificity were calculated using a 2 x 2 table with pathology results (75.9% of the patients) or clinical follow-up (24.1% of the cases) as the gold standard. Confidence interval (CI) estimations were performed using the Wilson score method.

All patients had the study requested for disease re-staging. A total of 42 scans were performed: 18 pts had 1 scan and 12 pts had 2 scans. The administered doses of 18F FDG ranged 10.5 - 20.0 mCi (average: 15.3 ± 2.31). PET/CT was 92.8% sensitive (95% CI: 66.4-99.9) and 92.8% specific (95% CI: 76.3-99.1) for detection of the primary lesion and 95.6% (95% CI: 77.3-99.9) sensitive and 94.7% specific (95% CI: 73.5-99.9) for metastases detection. The SUV max ranged 5.3-28.2 for the primary lesions (average: 12.5±6.96) and 2.8-22.9 for the metastases (average: 7.72±4.46). This difference was statistically significant (P value: 0.0058).

This study confirms the excellent results of 18F FDG PET/CT for identification of residual/recurrent disease in patients with advanced cervical cancer, as well as for distant metastases localization.

FDG PET/CT should be an integral part in evaluation of patients with high risk cervical cancer, prior to selection of the most appropriate therapy.

Iagaru, A, Rodriguez, C, El-Maghraby, T, Quon, A, Gambhir, S, McDougall, R, 18F FDG PET/CT Evaluation of Patients with Cervical Carcinoma.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5004294.html