Department of Nuclear Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea.
Clin Nucl Med. 2023 Nov 1;48(11):945-949. doi: 10.1097/RLU.0000000000004839. Epub 2023 Sep 18.
Gynecological cancer is the most prevalent cancer among women worldwide. We performed a meta-analysis to assess the impact of 18 F-FDG PET on the management of patients with recurrent gynecological cancers, including cervical, uterine, and ovarian cancers.
We systematically searched MEDLINE and EMBASE databases for English-language publications. All published studies on the impact of PET scans on the management of patients with recurrent gynecological cancers were reviewed. The proportion of management change (%), defined as the percentage of patients whose management changed after FDG PET to those who underwent FDG PET, was calculated. The data from each study were analyzed using MedCalc Statistical Software version 14.12.0 (MedCalc Software, Ostend, Belgium).
Nineteen studies including 6191 patients were eligible for inclusion. The impact of FDG PET scan for detecting recurrence/metastasis in patients with gynecologic cancer was evaluated using management change rates, ranging from 9.4% to 60.7% with a pooled effect of 42.0% (95% confidence interval [CI], 34.5%-49.6%; I2 = 92.9%). In the subtype analysis, FDG PET scanning resulted in changes in the management in 48.5% (95% CI, 37.8%-59.3%; I2 = 67.8%) of cervical cancer, 34.7% (95% CI, 33.4%-36.0%; I2 = 0%) of uterine cancer, and 40.3% (95% CI, 26.7%-54.7%; I2 = 95.2%) of ovarian cancer cases.
FDG PET has a significant impact on the restaging of patients with gynecological cancer. These findings suggest that FDG PET should be performed, especially in cases of suspected recurrence/metastasis in the main gynecologic cancer types, including cervical, ovarian, and uterine cancers.
妇科癌症是全球女性中最常见的癌症。我们进行了一项荟萃分析，以评估 18 F-FDG PET 对复发性妇科癌症患者管理的影响，包括宫颈癌、子宫癌和卵巢癌。
我们系统地检索了 MEDLINE 和 EMBASE 数据库中的英文出版物。对所有关于 PET 扫描对复发性妇科癌症患者管理影响的已发表研究进行了回顾。计算了管理变化的比例（%），定义为接受 FDG PET 后管理发生变化的患者比例，以及进行 FDG PET 的患者比例。使用 MedCalc Statistical Software 版本 14.12.0（MedCalc Software，Ostend，比利时）对来自每个研究的数据进行了分析。
19 项研究包括 6191 例患者符合纳入标准。使用管理变化率评估了 FDG PET 扫描在妇科癌症患者中检测复发/转移的作用，范围从 9.4%到 60.7%，合并效应为 42.0%（95%置信区间 [CI]，34.5%-49.6%；I2 = 92.9%）。在亚组分析中，FDG PET 扫描导致宫颈癌管理变化的比例为 48.5%（95% CI，37.8%-59.3%；I2 = 67.8%）、子宫癌为 34.7%（95% CI，33.4%-36.0%；I2 = 0%）和卵巢癌为 40.3%（95% CI，26.7%-54.7%；I2 = 95.2%）。
FDG PET 对妇科癌症患者的分期再评估有显著影响。这些发现表明，特别是在主要妇科癌症类型（包括宫颈癌、卵巢癌和子宫癌）中怀疑复发/转移的情况下，应进行 FDG PET。
