Carcinoma endometrium: Role of 18-FDG PET/CT for detection of suspected recurrence

Punit Sharma, Rakesh Kumar, Harmandeep Singh, Sunil Jeph, Daya Nand Sharma, Chandrasekhar Bal, Arun Malhotra

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

OBJECTIVE: 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. METHODS: 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. RESULTS: 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%). CONCLUSION: 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.

Original languageEnglish (US)
Pages (from-to)649-655
Number of pages7
JournalClinical nuclear medicine
Volume37
Issue number7
DOIs
StatePublished - Jul 2012

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

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