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KMID : 1148920140480020130
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Nuclear Medicine and Molecular Imaging
2014 Volume.48 No. 2 p.130 ~ p.136
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The Role of 18?F-FDG PET/CT in Assessing Therapy Response in Cervix Cancer after Concurrent Chemoradiation Therapy
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Choi Ji-Youn
Kim Hyun-Jeong
Jeong Yong-Hyu
Lee Jae-Hoon
Cho Arthur
Yun Mi-Jin
Lee Jong-Doo
Kim Yong-Bae
Kim Young-Tae
Kang Won-Jun
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Abstract
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Purpose: To determine whether persisting cervical fluorodeoxyglucose (FDG) uptake after concurrent chemoradiotherapy (CCRT) for cervical cancer can reflect residual malignancy.
Methods: F-FDG PET/CT was performed before and after CCRT in 136 patients with cervical cancer. The maximum and mean standardized uptake values (SUVmax and SUVmean) were recorded from PET/CT scans performed pre- and post-treatment. SUVs were correlated with treatment response after CCRT. Final treatment response was determined by MRI and further follow-up PET/CT. One hundred four of 136 patients underwent pelvic MRI, and 32 of 136 patients underwent further follow-up PET/CT. Patients were classified into two categories: patients with residual tumor or patients without residual tumor (complete responder). Pre- and post-treatment serum squamous cell carcinoma antigen (SCC) levels were also recorded for comparison. The optimal cutoff value of SUVmax for predicting residual cervical tumor was determined using receiver-operating characteristic (ROC) analysis.
Results: Of 136 patients, 124 showed complete response on further follow-up studies and 12 were confirmed to have residual tumor. The post-treatment SUVmax and pre-/post-treatment SUVmean of complete responders were significantly lower than those of patients with residual tumor: 2.5?±?0.8 and 7.2?±?4.2/1.9?±?0.7 for complete responders and 5.7?±?2.6 and 12.8?±?6.9/3.7?±?0.7 for patients with residual tumor (p?
Conclusions: Persistent cervical FDG uptake in18F-FDG PET/CT after CCRT for cervical cancer may be caused by residual tumor or post-therapy inflammation. A higher cutoff SUVmax than conventional criteria for cervical cancer in post-CCRT PET/CT might help to detect residual tumor.
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KEYWORD
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Cervical cancer, PET/CT, CCRT, Treatment response
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