Abstract
PurposeThe aim of this EANM / SNMMI Practice Guideline with ESTRO endorsement is to provide general information and specific considerations about [18F]FDG PET/CT in advanced uterine cervical cancer for external beam radiotherapy planning with emphasis on staging and target definition, mostly in FIGO stages IB3-IVA and IVB, treated with curative intention.MethodsGuidelines from related fields, relevant literature and leading experts have been consulted during the development of this guideline. As this field is rapidly evolving, this guideline cannot be seen as definitive, nor is it a summary of all existing protocols. Local variations should be taken into consideration when applying this guideline.ConclusionThe background, common clinical indications, qualifications and responsibilities of personnel, procedure / specifications of the examination, documentation / reporting and equipment specifications, quality control and radiation safety in imaging is discussed with an emphasis on the multidisciplinary approach.
Highlights
Primary staging of uterine cervical cancer is historically based on non-imaging clinical parameters determined by the International Federation of Gynecology and Obstetrics (FIGO) classification [1]
Imaging should be added to the workup and treatment planning of patients with cervical cancer when available, since it provides significant additional information to determine TNM stage [4] and the best choice of treatment, such as the relationship between primary cancer and adjacent tissue, lymph node involvement, and distant metastases [5]
The following considerations have led to the inclusion of [18F]FDG PET/Computed tomography (CT) in staging, additional to the historical FIGO/TNM staging in locally advanced cervical cancer: 1. Approximately one-half of patients with locally advanced cervical cancer have lymph node metastases at diagnosis. Detection of these nodes is essential for optimal treatment planning [28,29,30]. [18F]FDG PET/CT has a higher accuracy in detection of lymph node metastases compared to pure anatomical imaging in cervical cancer [31,32,33]
Summary
Guidelines from related fields, relevant literature and leading experts have been consulted during the development of this guideline. Local variations should be taken into consideration when applying this guideline
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