AIM: To evaluate the accuracy of (18)F-fluorodeoxyglucose (FDG) PET/ CT (PET/CT) in the diagnosis of suspected uterine cancer local recur- rence after treatment (surgery, chemotherapy and/or radiotherapy) and to assess the impact of PET/CT findings on clinical management, compared with contrast enhanced CT alone and MRI. METHODS: we retrospec- tively studied 64 women (mean age 72+5.2 yo) who underwent treatment for histopathologically proven uterine cancer. For the clinical-diagnostic suspect of local cancer recurrence, all patients underwent PET/CT exam- ination at least 3 months from the end of treatment. PET/CT results were correlated to contrast enhanced CT alone and MRI. Lesion status was determined on the basis of histopathology, radiological imaging and clin- ical follow-up for longer than 6 months. Differences among the three imaging modalities were tested using the Cochran Q test, followed by multiple comparisons using the McNemar test with Bonferroni adjust- ment. RESULTS: Patient-based analysis showed that PET/CT confirmed a local disease relapse in 35 patients (54.6%) out of 64. PET/CT data were confirmed by clinical-diagnostic and surgical follow-up. On the other hand CT alone showed a local recurrence of disease in 22 patients (34.3%). On the other hand MRI showed a relapse disease in 25 patients (39 %). The sensitivity, specificity, and accuracy of PET/CT were, respec- tively, 91%, 93%, and 92%; whereas those of contrast enhanced CT alone were, respectively, 68%, 87%, and 78%. Finally, sensitivity, specificity and accuracy of MRI were, respectively, 82%, 91% and 90%. PET/CT findings resulted in a change of management in 21 of 64 patients studied (32%). CONCLUSION: PET/CT is a more accurate modality for assessing recurrence of uterine cancer and more appropriate than contrast enhanced CT alone in the restaging of patient with suspected uterine cancer recurrence. MRI seems to be better then contrast enhanced CT for the restaging of local recurrence of uterine cancer but not performing like PET/CT. PET/CT done at least 3 months from the end of treatment allows to differentiate between after treatment local inflammation and tumour recovery. The change of treatment management gives a better prognostic stratification and restraint of costs. Data must be confirmed in a more large casistic.
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|Titolo:||Value of (18)F-fluorodeoxyglucose PET/CT in the diagnosis of local recurrence uterine cancer: comparison with CT and MRI|
|Data di pubblicazione:||2016|
|Appare nelle tipologie:||03.5 Abstract su rivista|