Introduction/Background Imaging follow up after radical treatment for cervical cancer with chemoradiotherapy and brachytherapy may be warranted if asymptomatic persistent or recurrent disease can be detected such that salvage treatment can be undertaken with curative intent. Since 2013, in Aberdeen Royal Infirmary, follow up MRI at 3 months and/or PET-CT at 9 months post-treatment have been organised for patients in whom salvage pelvic exenteration would be considered in the event of central recurrence.
Methodology All patients with cervical cancer treated non-surgically with curative intent between 2013 and 2018 at Aberdeen Royal Infirmary were identified from the radiotherapy database. Patients who had undergone a 3 month MRI and/or a 9 month CT-PET scan were identified and the results of these were collated, with the subsequent impact on patient management identified from the electronic patient record.
Results Twenty-nine and 32 patients underwent a post-treatment MRI and PET-CT scan respectively.
Following MRI, 16 patients had no residual disease (NRD) and have not relapsed to date, 5 had NRD but subsequently relapsed systemically, 5 had residual or new disease unsuitable for salvage, and 3 had potentially salvageable disease (1 undergoing exenteration but subsequently relapsing, 1 progressing prior to exenteration and 1 who did not pursue salvage).
Following PET-CT, 24 patients had NRD and have not relapsed to date, 7 had unsalvageable metastatic or pelvic disease and 1 had persistent pelvic side wall disease that was considered unsalvageable at the time but might now have been considered for salvage ablative radiotherapy.
Conclusion In our cohort, post treatment MRI at 3 months and/or PET-CT at 9 months have not led to any additional patients being cured of their cancer. The clinical utility of such scans may be limited to providing reassurance to patients with a negative scan, given the high negative predictive value in our series.
Disclosure Nothing to disclose.
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