Fusion images of Tl-201 SPECT and FDG PET with CT in detection of cervical carcinoma with bladder invasion.

Thallium-201 single-photon emission computed tomography (Tl-201 SPECT) and F-18 fluorodeoxyglucose positron emission tomography (FDG PET) are accurate and excellent methods for detecting malignant tumors and related metabolic abnormalities. However, there are still some limitations in clinical application. The major limitation of SPECT is poor image resolution. PET is less sensitive for detecting lesions of the urinary system adjacent to the bladder because of bladder radioactivity. Both T1-201 and F-18 FDG PET often provide less information than x-ray computed tomography (CT) about the anatomic landmarks needed to precisely locate lesions. Recent development of multimodality image registration and fusion has been shown to be an excellent tool to resolve these drawbacks. The authors present a rare case of residual cervical carcinoma with bladder invasion, which was detected by fusion imaging of Tl-201 SPECT and FDG PET with CT. This noninvasive image technique may become a valuable alternative to identify bladder invasion in cervical cancer.