Federico Laurel Ampil MD, Presenter: Nothing to Disclose

R Murty Krishnamsetty MD, Abstract Co-Author: Nothing to Disclose

James Unger MD, Abstract Co-Author: Nothing to Disclose

Richard Mansour MD, Abstract Co-Author: Nothing to Disclose

Radiotherapy (RT) represents a standard and potentially curative treatment for cervix cancer (CC). RT, when administered for locoregional tumor control, will be futile if all of the disease is not included within the radiation target volume. Our objective was to examine the appropriateness of PET in women with stage IB CC who were being evaluated for RT, and determine whether it really has an edge over CT imaging.

Twenty patients with stage IB CC who underwent whole-body FDG PET scans during the period from 2001 and 2003 are the subjects of this retrospective study. CT was also performed prior to the onset of RT in 15 of these same people. A positive PET finding meant grade 3 or 4 abnormality according to a system of degrees of FDG accumulation on images (Nakamoto 2002). Our usual criterion for lymph node metastasis on CT was a node size larger than 10 mm in diameter and/or the presence of central lucency (Shingaki 1995).

The detection of disease spread to the para-aortic nodes (which required extension of the field of irradiation) was approximately three times more by PET (20%) than by CT (7%), p>0.20). Similarly, pelvic nodal metastases were as often identified by FDG PET (55%) as by CT imaging (20%), p<0.05. There was only one example (only by PET) of imaging-demonstrated metastasis to the supraclavicular lymph node concomitantly present in a patient with para-aortic nodal disease.

The observations from this study suggest that PET is a more appropriate test than CT in the further evaluation of women with early stage CC prior to management by RT.

Ampil, F, Krishnamsetty, R, Unger, J, Mansour, R, FDG PET Imaging Evaluation of Extrapelvic Nodal Spread in Stage IB Cervix Cancer.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4402364.html