Performance of integrated FDG-PET/contrast-enhanced CT in the diagnosis of recurrent uterine cancer: Comparison with PET and enhanced CT

Kazuhiro Kitajima, Koji Murakami, Erena Yamasaki, Yasushi Domeki, Yasushi Kaji, Satoru Morita, Narufumi Suganuma, Kazuro Sugimura

Research output: Contribution to journalArticle

68 Citations (Scopus)

Abstract

Purpose: To evaluate the accuracy of integrated positron emission tomography and computed tomography (PET/CT) with iodinated contrast agent and 18F-fluorodeoxyglucose (FDG) in the diagnosis of suspected uterine cancer recurrence and to assess the impact of PET/CT findings on clinical management, compared with PET alone and enhanced CT alone. Methods: Of 103 women who had undergone treatment for histopathologically proven uterine cervical or endometrial cancer, 90 underwent FDG-PET/contrast-enhanced CT examination for suspected recurrence. PET-alone, CT-alone, and fused PET/CT images were interpreted by two radiologists by consensus for each investigation. Lesion status was determined on the basis of histopathology, radiological imaging and clinical follow-up for longer than 6 months. Differences among the three modalities were tested using the Cochran Q test, followed by multiple comparisons using the McNemar test with Bonferroni adjustment. Results: Patient-based analysis showed that the sensitivity, specificity, and accuracy of PET alone were 79.5% (35/44), 73.9% (34/46), and 76.7% (69/90), respectively, whereas those of CT alone were 68.2% (30/44), 87.0% (40/46), and 77.8% (70/90), respectively, and those of PET/CT were 90.9% (40/44), 93.5% (43/46), and 92.2% (83/90), respectively. PET/CT findings resulted in a change of management in 38 of the 90 patients (42%) with an additional effect on patient management in 13 patients (14%) diagnosed by CT alone and 14 patients (16%) diagnosed by PET alone. Conclusion: FDG-PET/contrast-enhanced CT is a more accurate modality for assessing recurrence of uterine cancer, and led to more appropriate subsequent clinical management than that resulting from PET alone or enhanced CT alone.

Original languageEnglish
Pages (from-to)362-372
Number of pages11
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume36
Issue number3
DOIs
Publication statusPublished - 2009 Mar

Keywords

  • FDG
  • PET/CT
  • Recurrence
  • Uterine cancer

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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