Article Text

Download PDFPDF
Utility of 18F-FDG-PET/CT imaging in patients with recurrent gynecological malignancies prior to pelvic exenteration
  1. Soyoun Rachel Kim1,
  2. Yoo-Young Lee1,2,
  3. Harinder Brar1,2,
  4. Arianne Albert3,
  5. Allan Covens1,4,5,
  6. Ur Metser4,5 and
  7. Taymaa May1,2
  1. 1 Division of Gynecology Oncology, Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada
  2. 2 Division of Gynecologic Oncology, Princess Margaret Cancer Center, University Health Network, Toronto, Ontario, Canada
  3. 3 Women’s Health Research Institute, Vancouver, British Columbia, Canada
  4. 4 Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
  5. 5 Sunnybrook Hospital, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Taymaa May, Division of Gynecology Oncology, Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON M5S, Canada; aymaa.May{at}uhn.ca

Abstract

Background In patients with recurrent gynecologic malignancies isolated to the pelvis, pelvic exenteration is a potential option. 18F-Fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT), is often used to confirm no evidence of metastatic disease.

Objective To assess the impact of PET/CT on clinical management of patients with recurrent gynecologic malignancies being considered for pelvic exenteration.

Methods Patients with recurrent gynecological malignancies who underwent PET/CT imaging between 2011 and 2014 were identified. All were considered for pelvic exenteration and underwent conventional imaging with CT +/- pelvic MRI. Patient anthropometric data, disease sites, histology, stage, treatment received, and treatment plan based on PET/CT findings were extracted.

Results A total of 40 patients met inclusion criteria. In 15 (37.5%) of these patients, results of PET/CT changed the original plan of pelvic exenteration owing to metastatic disease/unresectability (11/15) or no evidence of disease on PET/CT imaging (4/15). Twenty-five (62.5%) patients had their planned surgery after PET/CT with 19 (76%) patients undergoing a completed exenteration procedure. Six (24%) patients with PET/CT indicating isolated pelvic recurrence ultimately had intra-operative findings of extra-pelvic metastasis or nodal disease and therefore the planned surgery was aborted.

Conclusion In nearly 40% of patients with recurrent gynecologic malignancies being considered for radical salvage surgery, PET/CT can significantly alter the originally intended treatment and hence may reduce the number of futile surgical procedures.

Statistics from Altmetric.com

Footnotes

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Research ethics board (REB) approvals were obtained from the treating hospitals.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.