Application value of 18F-FDG PETCT imaging in the clinical initial diagnosis and follow-up of primary lesions of cervical cancer

Abstract

Background: Cervical cancer is a common malignant tumor in gynecology with a high death rate. his study aims to analyze the application value of 18F-fluorodeoxyglucose imaging examination (18F-FDG PETCT) imaging in the initial clinical diagnosis and follow-up examination of cervical cancer.

Methods: The clinical data of 71 patients with cervical lesions who were admitted to our hospital from March 2017 to March 2019 were retrospectively collected all patients underwent 18F-FDG PETCT examination. The results of the pathological examination were a benchmark to calculate the sensitivity, specificity, and accuracy of 18F-FDG PETCT imaging in the diagnosis of primary lesions of cervical cancer and the diagnosis of postoperative recurrence, residual, and metastasis.

Results: There were 39 patients initially suspected, and 30 cases were diagnosed as cervical cancer by pathological examination, including 22 cases with squamous cell carcinoma, 4 cases with adenocarcinoma, 3 cases with carcinoma in situ, and 1 case with adenosquamous carcinoma. The maximum standard uptake (SUVmax) value was (10.36±5.22), and the patient's lesions showed different degrees of increase of 18F-FDG metabolism. The necrotic area in the patient's lesion showed reduced/defect metabolism. The sensitivity of 18F-FDG PETCT imaging in the diagnosis of primary lesions of cervical cancer was 86.66%, specificity was 44.44%, and accuracy was 76.92%. In the 32 cases followed up for monitoring after the operation, 16 cases showed recurrence, metastasis, residual and other conditions, and 7 cases showed local recurrence/metastasis. 18F-FDG PETCT images showed: abnormal widening of the cervix, stump nodules/mass in the vagina, and rectal and bladder infiltration. All patients with local recurrence were treated with local tissue biopsy or surgical resection under 18F-FDG PETCT image localization. The diagnostic sensitivity, specificity and diagnostic coincidence rate of 18F-FDG PETCT imaging for postoperative follow-up of cervical cancer patients were 100%, 75.00% and 87.50%, respectively.

Conclusions: For patients with cervical cancer who are initially diagnosed or followed up, they can all be tested by 18F-FDG PETCT imaging, which can provide a reference for the formulation of diagnosis and treatment plan and the evaluation of prognosis.

Keywords: 18F-fluorodeoxyglucose imaging examination imaging (18F-FDG PETCT imaging); cervical cancer; follow-up; initial clinical diagnosis.

Figure 1

18F-FDG PETCT imaging of a typical case. 18F-FDG PETCT, 18F-fluorodeoxyglucose imaging examination. (A,B,C,D,E) 18F-FDG PETCT imaging showed that the cervical volume of patient was increased, the local soft tissue was thickened and glycometabolism was increased, which was considered as cervical Ca. (F,G) Multiple lymph nodes in the left carotid chain region (II, III, IV), the left posterior cervical triangle, the supraclavicular, mediastinal, retroperitoneal, left axillary, bilateral inguinal, pelvic, and para-aortic regions showed partial enlargement, fusion, and high glycometabolism, which was considered of the possibility of lymph node metastasis. (H) Local swelling of the left pubis, left iliopsoas, left gluteus medius, and high glucose metabolism, considering as metastasis.