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CC BY-NC-ND 4.0 · World J Nucl Med 2021; 20(02): 150-155
DOI: 10.4103/wjnm.WJNM_53_20
Original Article

Fluorodeoxyglucose positron-emission tomography-magnetic resonance hybrid imaging: An emerging tool for staging of cancer of the uterine cervix

Authors

  • Alina Nazir

    Department of Radiology, Stony Brook University Hospital in Stony Brook, NY, USA

  • Robert Matthews

    Department of Radiology, Stony Brook University Hospital in Stony Brook, NY, USA

  • Annapurneswara Chimpiri

    Department of Radiology, Stony Brook University Hospital in Stony Brook, NY, USA

  • Melissa Henretta

    1   Division of Gynecologic Oncology, Trinity Health of New England, Hartford, CT, USA

  • Joyce Varughese

    2   Gynecologic Oncology, Capital Health Surgical Group, Pennington, NJ, USA

  • Dinko Franceschi

    Department of Radiology, Stony Brook University Hospital in Stony Brook, NY, USA
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Abstract

Positron-emission tomography-magnetic resonance imaging (PET-MRI) is an emerging hybrid imaging modality that utilizes the superior soft tissue resolution of MR with the metabolic data from PET. In this study, we sought to assess the clinical value of fluorodeoxyglucose (FDG) PET-MRI with dedicated pelvic PET-MR in the initial staging of cervical cancer. In this institutional-approved study, we identified 23 adult females who underwent FDG PET-MRI on hybrid camera for staging of primary uterine cervical cancer that included a dedicated PET-MR of the pelvis. A nuclear medicine physician and a radiologist reviewed the PET, MRI, and fusion-body and pelvis images alone and then with consensus read characterizing PET and MR abnormal findings. There were 23 patients who underwent FDG PET-MRI for initial staging of cervical cancer with an average age of 52.2 ± 14.0 years. A total of 23 suspected lymph nodes in eight different patients were detected within the pelvis with increased metabolic activity on PET. Both the dedicated pelvis and whole-body PET imaging detected the same corresponding pelvic lymph nodes, although the pelvic PET imaging had better lymph node uptake delineation due to longer acquisition time. Using a 10-mm short-axis criterion, MRI identified only 43.5% of the FDG avid lymph nodes. The average SUVmax on the pelvis PET sequences was higher with SUV 8.9 ± 5.2 compared to the whole-body PET with SUV 7.8 ± 5.4 but was not statistically significant (P > 0.05). Primary cervical cancer was identified in 18 patients on both PET imaging and MRI with dedicated MR pelvis providing better characterization. Based on our results of the patients with cervical cancer evaluated for initial staging, combining dedicated pelvic PET-MRI with whole-body PET/MR provides the most complete status of malignant disease in reference to delineation of primary tumor, involvement of surrounding tissues, and regional lymph nodes.

Keywords

Cervical cancer - fluorodeoxyglucose - lymph nodes - positron-emission tomography-magnetic resonance imaging

Financial support and sponsorship

Nil.




Publikationsverlauf

Eingereicht: 04. Mai 2020

Angenommen: 06. Mai 2020

Artikel online veröffentlicht:
24. März 2022

© 2021. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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