Diagnostic role and prognostic impact of positron emission tomography/computed tomography in patients treated for uterine corpus cancer

Abstract

Introduction/Objective The goal of our research was to evaluate diagnostic and prognostic role of positron emission tomography/computed tomography (PET-CT) in patients previously treated for uterine cancer and compare it to conventional imaging methods (CIM).

Methods We analyzed 37 patients examined on PET-CT for follow-up or suspicion of uterine cancer recurrence, and who were previously treated with surgery and/or chemoradiotherapy. All patients underwent CT or magnetic resonance imaging prior to PET-CT, and were followed-up for at least one year.

Results PET-CT showed sensitivity, specificity and diagnostic accuracy in uterine cancer relapse detection of 96.3%, 70%, and 89.2%, while those values for CIM were 92.6%, 40%, and 78.4 %, respectively. Correlation of PET-CT and CIM findings was 78% (29/37). In 13 out of 25 true positive patients on CIM, PET-CT found greater number of active sites missed by conventional imaging. Positive findings on PET-CT were associated with shorter progression free survival (p = 0.023, logrank test).

Conclusion PET-CT constitutes an important diagnostic method in management of recurrent cancer of uterine corpus, demonstrating high sensitivity and accuracy. In comparison to CIM, PET-CT can discover larger number of active tumor sites, and also shows better specificity. PET-CT positive patients have worse prognosis with shorter progression free survival.

Keywords: endometrial cancer; fluorodeoxyglucose; progression free survival; sensitivity; specificity; uterine sarcoma