Author(s): Sandvik RM, Jensen PT, Hendel HW, Palle C
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Abstract INTRODUCTION: Many studies have found that positron emission tomography-computed tomography (PET-CT) has a high sensitivity and specificity in the identification of metastasis in cervical cancer. Herlev Hospital, Denmark, has been performing PET-CTs in stage I-IV cervical cancer since 1 May 2006. The present study investigates the positive (PPV) and negative predictive value (NPV) of PET-CT in stage I disease and the clinical impact of the scan results in all disease stages. MATERIAL AND METHODS: In this retrospective study, 83 consecutive patients with cervical cancer were included between 1 May 2006 and 1 November 2007. Data were collected from patient records and PET-CT reports. RESULTS: Among 47 stage I patients, four had PET-positive findings on the scan in addition to cervical cancer. Only one was a true positive finding. Pelvic lymphadenectomy was performed in 36 stage Ia2-Ib1 patients. Histology from stage I patients revealed a PPV of 25\% and a NPV of 88\%. Among a total of 36 stage II-IV patients, 14 had PET-positive findings. Five patients had a biopsy performed. Three of these patients were true positives and two were true negatives. Taking of biopsies in the remaining patients was clinically irrelevant. Five patients (6\%), all in stage ≥ IIb, were offered an alternative treatment owing to the additional information obtained from the PET-CT. CONCLUSION: PET-CT is useful in the identification of metastatic disease in cervical cancer and it may assist optimal treatment planning; especially in International Federation of Gynecologists & Obstetricians (FIGO) stage > I cancers. Histological verification of PET-positive findings is necessary. The clinical value of PET-CT in early stage cervical cancer may be questioned.
This article was published in Dan Med Bull
and referenced in Journal of Cancer Science & Therapy