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2022-RA-862-ESGO Simultaneous 18F-FDG PET/MRI as single imaging method in the assessment of cervical cancer- a pilot study
  1. Elisabeth Hedlund1,
  2. Björg Jonsdottir2,
  3. Håkan Ahlström1 and
  4. Karin Stålberg2
  1. 1Uppsala University, Department of Surgical Sciences, Section of Radiology, Uppsala, Sweden
  2. 2Uppsala University, Department of Women’s and Children’s Health, Uppsala, Sweden


Introduction/Background Simultaneous PET/MRI is a relatively new imaging method, and its role in diagnostics of gynaecologic cancer is unclear. The aim of the present study is to investigate the use of PET/MRI in the assessment of cervical cancer and its potential to be used as a single imaging method.

Methodology In 2015–2016, 15 patients with primary cervical cancer FIGO stage IB or higher, at Akademiska Sjukhuset, Uppsala, Sweden, were prospectively enrolled for a simultaneous whole-body 18F-FDG (Fluorodeoxyglucose) PET/MRI.The PET/MRI images were evaluated in consensus by a fourth-year resident in radiology and a senior consultant for the following parameters; maximal tumor size, SUV-max, direct tumor extension to adjacent structures as the parametrium and pelvic wall, corpus, vagina, ovaries, presence of lymph nodes metastases and distant metastasis. The results of staging from PET/MRI were compared with standard radiology (Diffusion weighted-MRI and CT or PET/CT) and clinical staging. Furthermore, the separate contribution of the PET component in PET/MRI was analysed.

Results Five of the patients were treated with primary surgery and ten with radio-chemotherapy. In nine patients, staging with PET/MRI differed from clinical staging, whereof eight where upstaged (table 1). PET/MRI and standard imaging methods were comparable in detecting tumor extension and equally good at detecting lymph node metastases and distant metastases. The radiologists experienced more certainty in analysing malignant lesions with the additional information of PET, however, the lesions were more easily defined on MRI.

Abstract 2022-RA-862-ESGO Table 1

Staging in cervical cancer. Comparison of integrated PETMRI, standard imaging methods and clinical examination

Conclusion The present study indicates that PET/MRI gives similar staging results as routine imaging methods in staging of cervical cancer. Presumably, PET/MRI as a single imaging method, could replace the common standard of MRI and PET/CT in advanced cervical cancer and thus shorten time to start of treatment and save resources.

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