ABSTRACT
PURPOSE: The purpose of this study was to assess the role of fluorine 18 ((18)F)-fluorodeoxyglucose positron emission tomography-computed tomography ((18)F-FDG PET-CT) in evaluating various parameters in patients with surgical scar site recurrence in cervical carcinoma. METHODS: Data of all patients with cervical cancer (n = 329) who underwent PET-CT at our institute between 2005 and 2013 was reviewed. Of these 329 patients, 132 patients who were surgically treated and underwent restaging/follow-up PET-CT were included in the present study for final analysis. Tumor recurrence at the abdominal surgical scar site was looked for. Abnormal uptakes suggestive of active disease at other sites were also noted. Maximum standardized uptake value was measured for all the lesions. Patients with scar site recurrence were taken as cases (n = 6), whereas the remaining patients served as controls (n = 126). Comparison with conventional imaging modalities was made wherever available. Histopathological examination was always sought for. RESULTS: The incidence of scar site recurrence after surgery was found to be 4.5% (6/117). A total of 56 of 132 patients had recurrent disease, including 6 patients with scar site recurrence. All of the patients with scar site recurrence also had recurrent disease at other sites (local, nodal, or distant). Conventional imaging modalities were available in 4 of these 6 patients and detected scar site recurrence in 3 of those 4 patients. In patients with scar site recurrence, the mean ± SD time to scar site recurrence was 14.0 ± 10.9 months (median, 10 months; range, 7-36 months). Significant difference was seen between cases and control for International Federation of Genecology and Oncology stage (P = 0.001) and nodal recurrence (P = 0.007). Additionally, age, nodal recurrence, distant recurrence, and scar site recurrence were significantly associated with death. CONCLUSIONS: Scar site recurrence carries a poor prognosis, and the incidence is much higher than previously known when PET-CT is used as a modality for its detection.
Subject(s)
Carcinoma/diagnostic imaging , Cicatrix/diagnostic imaging , Neoplasm Recurrence, Local/diagnostic imaging , Uterine Cervical Neoplasms/diagnostic imaging , Adult , Aged , Case-Control Studies , Female , Fluorodeoxyglucose F18 , Humans , Middle Aged , Positron-Emission TomographyABSTRACT
Is there a need for the contrast-enhanced PET/computed tomography (CT) scan or is the low-dose, non-contrast-enhanced PET/CT scan sufficient? The topic has been debated time and again. Although low-dose noncontrast CT serves the purpose of simple anatomic correlation and attenuation correction of PET images, many times patients have to undergo additional contrast-enhanced diagnostic imaging modalities, which may lead to a delay in decision-making. In this review, the authors have addressed various such issues related to the use of contrast agents and special techniques of clinical interest based on their utility in dual-modality PET/CT.
Subject(s)
Contrast Media/administration & dosage , Multimodal Imaging/methods , Positron-Emission Tomography/methods , Tomography, X-Ray Computed/methods , Contrast Media/adverse effects , Female , Humans , MaleABSTRACT
We present a rare case of Rosai-Dorfman disease who was sent for whole-body 18F-FDG PET/CT to know the exact extent of involvement. PET/CT revealed extensive nodal and extranodal involvement from head to toe including osteolytic lesions in metacarpals, metatarsals, and phalanges. It is important to know the exact extent of the disease as this may alter the patient management.
