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J Nucl Med. 2008; 49 (Supplement 1):256P
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General Clinical Specialties: General Practice-Oncology

General Practice-Oncology Posters

F-18 FDG PET/CT imaging of cervical cancer treated with intensity modulated radiation therapy (IMRT): An initial experience

Saabry Osmany1, J. Weidhaas2 and I. Doddamane1

1 Diagnostic Radiology; 2 Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut

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Objectives: To assess the role of FDG PET/CT in patients(pts) with cervical cancer before and after IMRT and to determine outcomes.

Methods: 9 pts with FIGO stage III or IV(7/9) or recurrent cervical cancer(2/9) were staged by multiple PET/CT studies between 2004 and 2007. Each pt was scanned for IMRT treatment planning, 2-6 months post-IMRT and every 3-6 months to assess for disease persistence, resolution, progression or recurrence. PET/CT findings were correlated with clinical progress and where available pre-IMRT CT and MRI findings. Treatment included IMRT and weekly sensitizing low-dose cisplatin chemotherapy for all pts.

Results: PET/CT allowed better initial staging than CT or pelvic MRI alone. The PET/CT findings determined the extent of the IMRT field in all 9 pts. IMRT was particularly helpful in identifying involved paraaortic lymph nodes that were borderline on CT. Pts with no activity on first post-IMRT PET/CT scans remained disease free up to 3 years(2/8), while persistent activity either represented inflammation requiring no further treatment(3/8) or represented residual(1/8) or new disease(2/8). Overall disease free survival is 75% as one pt with new disease was salvaged.

Conclusions: Our study suggests that pretreatment F18 FDG PET/CT provides more accurate staging than CT or pelvic MRI allowing for appropriate radiation field delineation. Initial post-IMRT studies appear to have a good negative predictive value and positive studies often represent only inflammation. In our study we have found a good response to IMRT thus far. To strengthen the study we plan to recruit more pts and to continue monitoring our current group to identify ways to differentiate between inflammation vs. persistent disease.





This Article
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Right arrow Email this article to a friend
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Right arrow Alert me to new issues of the journal
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Right arrow Articles by Osmany, S.
Right arrow Articles by Doddamane, I.
PubMed
Right arrow Articles by Osmany, S.
Right arrow Articles by Doddamane, I.