Clinical impact of FDG-PET for follow-up patients with gynecological malignancies

Purpose. To study the clinical value of FDG-PET for recurrent gynecological malignancies. Methods. Twenty patients who underwent surgery and/or chemoradiotherapy for histopathologically-proven gynecological malignancies were studied. Among them, 11 patients were suspected of having recurrence by conventional imaging modalities (CIM) or the increase of serum tumor markers (group A), and nine patients were clinically disease free (group B). Based on the PET images without attenuation correction. abnormal accumulations were compared with CIM and were related to the final diagnoses obtained by histopathology or clinical follow-up. Results. In group Al 12 lesions in eight patients were detected by whole-body PET, including nine tumors suspected as recurrences ol metastases only by PET. In two patients, PET was negative and further clinical follow-up revealed no signs of recurrence. In the remaining one patient, PET showed no abnormal accumulation. but cytology of ascites was positive. On the other hand, in group B, PET demonstrated one histologically confirmed recurrent case, six true negative cases, one false positive case, and one false negative case. Sensitivity, specificity and accuracy were 81.8, 88.9, and 85.0%, respectively. Conclusion. Our preliminary data suggest that whole-body FDG-PET can have a clear impact on the management and follow-up of patients with gynecological malignancies.