Detection of recurrence by 18F-FDG PET in patients with endometrial cancer showing no evidence of disease

Abstract

This study assessed the feasibility of F-18-fluorodeoxyglucose positron-emission tomography ((18)F-FDG PET) in the post-therapy surveillance for patients with endometrial cancer showing no evidence of disease (NED). From April 1997 to June 2007, 127 patients with endometrial cancer showing NED were performed (18)F-FDG PET scan. The feasibility of (18)F-FDG PET for the early detection of recurrence in patients with endometrial cancer was evaluated retrospectively. Of the 127 patients, 32 patients showed positive lesions on (18)F-FDG PET scan. Nineteen (19/127 cases, 15%) of them were confirmed to have a recurrence clinically or histologically. The sensitivity, specificity and positive and negative predictive value of (18)F-FDG PET for detecting recurrences in patients with endometrial cancer were 100%, 88%, 59% and 100%, respectively. In conclusion, (18)F-FDG PET may be a useful method for the post-therapy surveillance in patients with endometrial cancer.

Keywords: Endometrial Neoplasms; Positron-Emission Tomography; Recurrence.

Fig. 1

A case where ¹⁸F-FDG PET detected a recurrent lesion in a patient showing no evidence of disease at conventional studies. CT scan detected no lesion and the level of tumor marker was within normal range. However, PET scan detected a recurrent lesion (arrow) at small bowel mesentery. Retrospective review of CT scan revealed a lesion smaller than 1 cm (arrow) at small bowel mesentery. Bowel obstruction symptoms developed three weeks later and surgical exploration revealed a recurrent lesion at small bowel mesentery.

Fig. 2

Interval from the initial diagnosis to ¹⁸F-FDG PET for the patients with endometrial cancer who had recurrent disease.