Clinical impact of positron emission tomography or positron emission tomography/computed tomography in the posttherapy surveillance of endometrial carcinoma: evaluation of 88 patients

• Published in: International journal of gynecological cancer Vol. 18; no. 6; pp. 1332 - 1338
• Main Authors: Park, J-Y, Kim, E N, Kim, D-Y, Kim, J-H, Kim, Y-M, Kim, Y-T, Nam, J-H
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.11.2008
• Subjects: Adult; Aged; Asymptomatic; Endometrial cancer; Endometrial Neoplasms - diagnosis; Endometrial Neoplasms - drug therapy; Endometrial Neoplasms - radiotherapy; Endometrial Neoplasms - surgery; Female; Follow-Up Studies; Humans; Middle Aged; Positron-Emission Tomography - methods; Recurrence; Sensitivity and Specificity; Surveillance; Tomography; Tomography, X-Ray Computed - methods
• ISSN: 1048-891X; 1525-1438
• DOI: 10.1111/j.1525-1438.2008.01197.x

The objective of this study was to evaluate the validity and clinical impact of positron emission tomography (PET) or positron emission tomography/computed tomography (PET/CT) using 18-fluoro-2-deoxy-D-glucose in the posttherapy surveillance of patients with endometrial carcinoma. Eighty-eight patients previously treated for histopathologically diagnosed endometrial adenocarcinoma underwent 99 PET or PET/CT scans at follow-up visits at Asan Medical Center, Seoul, Korea, between 2001 and 2007. The standard of reference for tumor recurrence consisted of histopathologic confirmation or follow-up information at least 6 months after PET or PET/CT. Of the 88 patients, 24 underwent PET (n = 11) and/or PET/CT (n = 14) scans due to suspected disease recurrence. The sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of PET and/or PET/CT in detecting recurrence in these patients were 100%, 83.3%, 96%, 95%, and 100%, respectively. Especially, PET/CT revealed true-positive findings in three patients with elevated tumor markers but negative CT findings. The remaining 64 patients underwent PET (n = 8) and/or PET/CT (n = 66) as part of routine posttherapy surveillance; these patients were asymptomatic, with no evidence of disease. The sensitivity, specificity, accuracy, PPV, and NPV of PET and/or PET/CT in detecting recurrence in these patients were all 100%. Clinical decisions on treatment were changed in 14 (21.9%) patients by introducing PET or PET/CT into their conventional posttherapy surveillance program. PET and/or PET/CT were highly effective in discriminating true recurrence in patients with suspected recurrence, highly sensitive in detecting recurrence in asymptomatic patients, and had impacts on clinical decisions in a considerable portion of patients.