Value of 18F-FDG PET/CT in patients with cancer of the uterine cervix having elevated serum squamous cell carcinoma antigen after treatment

Abstract

Objective To evaluate the clinical value of 18F-FDG PET/CT in the detection of residual, recurrent and metastatic diseases in post-treatment uterine cervical cancer patients presenting with elevated serum squamous cell carcinoma (SCC) antigen levels. Methods Between March 2009 and October 2012, 18F-FDG PET/CT was performed in 48 patients(average age (47.5±11.2) years) with suspected residual, recurrent or metastatic uterine cervical cancer because of increased serum SCC antigen level (>1.5 μg/L). The final diagnosis was established by pathology or more than 1 year of clinical follow-up. The diagnostic efficiency of 18F-FDG PET/CT was calculated. Two-sample t test was used for data analysis. Results The serum SCC levels were 1.6-42.5(mean: 8.6±9.4) μg/L. Among the 48 patients, 45 (93.75%) were confirmed of having malignant lesions. 18F-FDG PET/CT along with other imaging detected 174 lesions, of which 169 were proven as residual, recurrent or metastatic diseases. 18F-FDG PET/CT correctly identified 159 lesions, yielding a diagnostic sensitivity and accuracy of 94.08%(159/169) and 91.38%(159/174), respectively. The diagnostic sensitivity and accuracy for residual and recurrent diseases were both 9/10; for lymph node metastasis were 94.59%(105/111) and 92.92%(105/113), respectively; and for other sites of metastasis were 93.75% (45/48) and 88.24%(45/51), respectively. There was no significant difference of SUVmax between the patients with residual/recurrent disease (mean: 6.9±3.8, range: 2.0-13.7) and those with metastasis (mean: 6.3±2.7, range: 2.0-14.4,t=0.629, P>0.05). Conclusion 18F-FDG PET/CT is valuable for the detection of residual, recurrent and metastatic diseases in the uterine cervical cancer patients presenting with elevated serum squamous cell carcinoma antigen after conventional treatment. Key words: Cervix neoplasms; Neoplasm recurrence, local; Neoplasm metastasis; Antigens; Tomography, emission-computed; Tomography, X-ray computed; Deoxyglucose