The clinical value of PET and PET/CT in the diagnosis and management of suspected cervical cancer recurrence.

Abstract

The aim of this study was to evaluate the clinical value of PET and PET/CT in suspected recurrent cervical cancer. The recurrence of cervical cancer has a poor prognosis. Earlier intervention would lead to a better prognosis. PET and PET/CT were promising in early diagnosis of recurrence because they could detect the biological and molecular changes before the anatomical size changes occurred. However, few data concerning the clinical effect of PET and PET/CT were available. The database for PET (or positron emission tomography or FDG or fluorodeoxyglucose) AND cervical cancer (or cervical tumor or cervical neoplasm or cervical carcinoma) AND recurrence or relapse was searched. The diagnostic value of PET or PET/CT was evaluated in both person-based and region-based analyses. Seventeen studies with 707 cases were included in the meta-analysis. For patients who were suspected of cervical cancer recurrence, the pooled sensitivity of PET and PET/CT was 0.97 (0.95-0.99). For patients who were suspected of relapse owing to elevated squamous cell carcinoma antigen, the pooled sensitivity was 0.99 (0.93-1.00). Moreover, the region-based diagnostic value in lung, mediastinum, liver/spleen, inguinal lymph node, supraclavicular lymph node, and para-aortic lymph node was high, from which we can see that PET and PET/CT had a favorable diagnostic value on distant metastasis. In addition, 57% of the therapeutic plans were modified owing to PET and PET/CT. PET and PET/CT are valuable tools in suspected recurrence of cervical cancer and provide valuable information for treatment decisions.