Comparison of positron emission tomography/computed tomography and magnetic resonance imaging for posttherapy evaluation in patients with advanced cervical cancer receiving definitive concurrent chemoradiotherapy

  • Tzu-Pei Su
  • Gigin Lin
  • Yu-Ting Huang
  • Feng-Yuan Liu
  • Chun-Chieh Wang
  • Angel Chao
  • Hung-Hsueh Chou
  • Tzu-Chen Yen
  • Chyong-Huey Lai
Original Article

Abstract

Purpose

Our purpose was to assess the diagnostic performance of positron emission tomography/computed tomography (PET/CT) and pelvic/abdominal magnetic resonance imaging (MRI) after concurrent chemoradiotherapy (CCRT) for posttherapy evaluation in patients with advanced cervical cancer.

Methods

Patients with cervical squamous cell carcinoma, either with advanced FIGO stage or with positive pelvic or para-aortic lymph node (PALN), received PET/CT using [18F]fluorodeoxyglucose and MRI including diffusion-weighted imaging between 2 and 3 months after CCRT completion. PET/CT were interpreted independently by two nuclear medicine physicians and MRI by two radiologists using the same scoring system. Active residual tumor was proven by pathological confirmation or disease progression on imaging studies within one year after CCRT and the disease regions were classified as local, regional, PALN, or distant. Patient-based and region-based comparison was performed using the receiver operating characteristic curve analysis.

Results

The study included 55 patients and 15 (27%) patients had active residual tumor. The diagnostic performance of PET/CT is significantly superior to that of MRI in patient-based analysis (P = 0.025) and in the detection of local (P = 0.045) and regional (P = 0.014) disease. The patient-based sensitivity, specificity, and accuracy of PET/CT are 60%, 100%, and 89% while those of MRI are 27%, 100%, and 80%.

Conclusions

PET/CT is superior to MRI for posttherapy evaluation in patients with advanced cervical cancer 2–3 months after definitive CCRT, mainly for the detection of residual local and regional disease. Patients with negative or equivocal results should be followed up regularly due to suboptimal sensitivities of imaging.

Keywords

PET/CT MRI Cervical cancer Diagnostic performance Posttherapy evaluation 

Notes

Acknowledgements

This study was financially supported by grants from the Chang Gung Memorial Hospital (CMRPG381141 and CMRPG381142), Taiwan.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  • Tzu-Pei Su
    • 1
  • Gigin Lin
    • 2
    • 3
  • Yu-Ting Huang
    • 2
    • 4
  • Feng-Yuan Liu
    • 2
    • 5
  • Chun-Chieh Wang
    • 2
    • 6
  • Angel Chao
    • 2
    • 7
  • Hung-Hsueh Chou
    • 2
    • 7
  • Tzu-Chen Yen
    • 2
    • 5
    • 7
  • Chyong-Huey Lai
    • 2
    • 7
  1. 1.Department of Nuclear MedicineChang Gung Memorial Hospital Keelung BranchKeelungTaiwan
  2. 2.Gynecologic Cancer Research CenterChang Gung Memorial Hospital and Chang Gung University College of MedicineTaoyuanTaiwan
  3. 3.Department of Medical Imaging and Intervention, Clinical Metabolomics Core Lab, Imaging Core Lab, Institute for Radiological ResearchChang Gung Memorial Hospital and Chang Gung University College of MedicineTaoyuanTaiwan
  4. 4.Department of Diagnostic RadiologyChang Gung Memorial Hospital Keelung BranchKeelungTaiwan
  5. 5.Department of Nuclear Medicine and Molecular Imaging CenterChang Gung Memorial Hospital and Chang Gung University College of MedicineTaoyuan CountyTaiwan
  6. 6.Department of Radiation OncologyChang Gung Memorial Hospital and Chang Gung University College of MedicineTaoyuanTaiwan
  7. 7.Department of Obstetrics and GynecologyChang Gung Memorial Hospital and Chang Gung University College of MedicineTaoyuanTaiwan

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