The role of 18F-FDG PET in assessing therapy response in cancer of the cervix and ovaries

J Nucl Med. 2009 May:50 Suppl 1:64S-73S. doi: 10.2967/jnumed.108.057257. Epub 2009 Apr 20.

Abstract

For locally advanced cervical cancer, the current literature supports the use of (18)F-FDG PET for assessing treatment response 3 mo after the completion of concurrent chemoradiation. (18)F-FDG PET can provide reliable long-term prognostic information for these patients and, in the future, may be used to guide additional therapy. Investigational areas include the use of (18)F-FDG PET for monitoring response during radiotherapy and chemotherapy in the metastatic and neoadjuvant settings. For ovarian masses, the performance of (18)F-FDG PET in the detection of borderline tumors is limited, and the presence of physiologic (18)F-FDG uptake in normal ovaries of premenopausal women poses another limitation. Preliminary data suggest that the performance of (18)F-FDG PET and (18)F-FDG PET/CT is superior to that of CT alone in initial staging, but the sensitivity of both in the detection of carcinomatosis is limited. Preliminary data also suggest that (18)F-FDG PET may be promising for early prediction of response to chemotherapy and for prediction of response after the completion of chemotherapy. (18)F-FDG PET and (18)F-FDG PET/CT are most helpful in the evaluation of patients with suspected recurrent ovarian carcinoma, especially when CA-125 levels are rising and CT findings are normal or equivocal. PET and CT are complementary, and PET/CT should be used when available. Preliminary data suggest that the addition of (18)F-FDG PET/CT to the evaluation of these patients changes management in approximately a third and reduces overall treatment costs by accurately identifying patients who will or will not benefit from surgery.

Publication types

  • Review

MeSH terms

  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Ovarian Neoplasms / diagnosis*
  • Ovarian Neoplasms / therapy*
  • Positron-Emission Tomography / methods*
  • Prognosis
  • Radiopharmaceuticals
  • Subtraction Technique
  • Tomography, X-Ray Computed / methods*
  • Treatment Outcome
  • Uterine Cervical Neoplasms / diagnosis*
  • Uterine Cervical Neoplasms / therapy*

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18