New trends in the evaluation and treatment of cervix cancer: the role of FDG-PET.

ABSTRACT

INTRODUCTION: Positron emission tomography (PET) with F18 Flurodeoxyglucose (FDG) has been evaluated and found to be a useful diagnostic tool in a certain number of malignancies, particularly in providing crucial assessment of metabolic activity of the tumour. We herein review and discuss the place and role of FDG-PET scan in cervix carcinoma patients' management. MATERIALS AND METHODS: Data for this review were identified by searches of Medline with and without MeSH database and Cancerlit. Studies were selected only if they were randomised clinical trials or historical reports. References were also identified from reference lists in relevant previously published articles. Recent guidelines and meta-analyses were included. Only published articles were taken into consideration. RESULTS: Although FDG-PET may be useful in the primary cervical tumours morphologic and metabolic evaluation, it seems to have limited place for disease staging in patients with early-stage disease (less than 4 cm). Hybrid PET/CT is an effective imaging technique in the lymph node staging of locally advanced cervix carcinoma with negative CT findings and may lead to substantial changes in treatment planning for several patients. FDG-PET provides meaningful information for the early evaluation of therapeutic response and long-term follow-up. CONCLUSION: Several reports have demonstrated the efficacy of FDG-PET in both pre-treatment staging and post-treatment evaluation of patients with cervical carcinoma. Further evaluation in prospective clinical trials will be required to assess the clinical benefit of this strategy.