Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.
Clin Nucl Med. 2012 Jul;37(7):649-55. doi: 10.1097/RLU.0b013e31824d24fa.
Recurrent carcinoma endometrium has a poor prognosis. However, successful salvage with long-term survival has been achieved after hormone therapy, radical surgery, and radiotherapy/chemotherapy in patients with recurrent disease. Conventional imaging (CI) and tumor marker have limited accuracy for detecting recurrence in these patients. The aim of the present study was to evaluate the role of 18-flurodeoxyglucose (FDG) positron emission tomography-computed tomography (PET/CT) in patients suspected to have recurrence of carcinoma endometrium.
In this retrospective study, total 101 patients were evaluated. All patients had undergone surgery with/without adjuvant therapy (chemotherapy/radiotherapy/both) for histologically proven carcinoma endometrium. They underwent 18-FDG PET/CT studies for suspected recurrence. Comparable CI (contrast-enhanced CT and/or magnetic resonance imaging) was available for 76 patients. Results of FDG PET/CT were confirmed with clinical/imaging follow-up and/or histopathology.
The mean age was 56.9±8.6 years. 18-FDG PET/CT was positive for recurrence in 51 (50.5%) patients and negative in 50 (49.5%). Locoregional disease was observed in 24 patients, metastatic disease was observed in 10, and 17 showed both locoregional and metastatic disease. The sensitivity, specificity, positive and negative predictive values, and accuracy of 18-FDG PET/CT were 88.9%, 93.6%, 94.1%, 88%, and 91%, respectively. 18-FDG PET/CT showed strong positive correlation with final diagnosis based on reference standard (κ 0.823; P=0.0001). Compared to CI, 18-FDG PET/CT has much higher specificity (62% vs. 96.4%), and accuracy (76.3% vs. 92.1%), with comparable sensitivity (85.1% vs. 89.5%).
18-FDG PET/CT is a highly sensitive and specific modality for detecting recurrence in post-therapy patients of carcinoma endometrium with suspected recurrence. It performs better than CI.
复发性子宫内膜癌预后较差。然而，对于复发性疾病患者，激素治疗、根治性手术和放化疗后，已有长期生存的成功挽救案例。在这些患者中，常规影像学（CI）和肿瘤标志物对检测复发的准确性有限。本研究旨在评估 18-氟脱氧葡萄糖（FDG）正电子发射断层扫描-计算机断层扫描（PET/CT）在疑似复发性子宫内膜癌患者中的作用。
在这项回顾性研究中，共评估了 101 名患者。所有患者均经手术治疗，术后辅以（化疗/放疗/两者联合）辅助治疗，用于组织学证实的子宫内膜癌。他们因疑似复发而行 18-FDG PET/CT 检查。76 名患者可获得可比的 CI（增强 CT 和/或磁共振成像）。FDG PET/CT 结果通过临床/影像学随访和/或组织病理学证实。
患者的平均年龄为 56.9±8.6 岁。18-FDG PET/CT 对 51 例（50.5%）患者的复发呈阳性，对 50 例（49.5%）患者的复发呈阴性。24 例患者出现局部区域疾病，10 例患者出现远处转移疾病，17 例患者同时出现局部区域和远处转移疾病。18-FDG PET/CT 的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为 88.9%、93.6%、94.1%、88%和 91%。18-FDG PET/CT 与基于参考标准的最终诊断具有很强的正相关性（κ 0.823；P=0.0001）。与 CI 相比，18-FDG PET/CT 的特异性（62%对 96.4%）和准确性（76.3%对 92.1%）更高，而敏感性（85.1%对 89.5%）相当。
18-FDG PET/CT 是一种高度敏感和特异的检测方法，可用于检测疑似复发的治疗后子宫内膜癌患者的复发。其性能优于 CI。
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