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Gynecological Tumors

  • Farrokh Dehdashti
  • Barry A. Siegel
Chapter

Abstract

Gynecological cancers as a group comprise approximately 11% of female cancer (1). In the United States, it is estimated that nearly 78,290 women will be diagnosed in 2007 with gynecological cancers and that approximately 28,000 women will die as a result of these cancers (accounting for 10% of all cancer-related deaths in women). Gynecological cancers are typically diagnosed by history, physical examination, and selected imaging studies. There has been an increasing use of PET using 18,F-fluorodeoxyglucose (FDG) for staging and restaging of these cancers, as well as for assessing response to therapy (2).

Keywords

Cervical Cancer Endometrial Cancer Positive Predictive Value Negative Predictive Value National Comprehensive Cancer Network 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    American Cancer Society. Cancer Facts & Figures 2009. Atlanta: American Cancer Society; 2009.Google Scholar
  2. 2.
    Lai CH, Yen TC, Chang TC. Positron emission tomography imaging for gynecologic malignancy. Curr Opin Obstet Gynecol 2007;19:37–41.CrossRefPubMedGoogle Scholar
  3. 3.
    Havrilesky LJ, Kulasingam SL, Matchar DB, Myers ER. FDG-PET for management of cervical and ovarian cancer. Gynecol Oncol 2005;97:183–191.CrossRefPubMedGoogle Scholar
  4. 4.
    Choi HJ, Roh JW, Seo SS, Lee S, Kim J-Y, Kim S-K, Kang KW, Lee JS, Jeong JY, Park S-Y. Comparison of the accuracy of magnetic resonance imaging and positron emission tomography/computed tomography in the presurgical detection of lymph node metastases in patients with uterine cervical carcinoma: A prospective study. Cancer 2006;106:914–922.CrossRefPubMedGoogle Scholar
  5. 5.
    Loft A, Berthelsen AK, Roed H, Ottosen C, Lundvall L, Knudsen J, Nedergaard L, Højgaard L Engelholm SA. The diagnostic value of PET/CT scanning in patients with cervical cancer: a prospective study. Gynecol Oncol 2007;106:29–34.CrossRefPubMedGoogle Scholar
  6. 6.
    Wright JD, Dehdashti F, Herzog TJ, Mutch DG, Huettner PC, Rader JS, Gibb RK, Powell MA, Gao F, Siegel BA, Grigsby PW. Preoperative lymph node staging of early-stage cervical carcinoma by [18F]-fluoro-2-deoxy-D-glucose-positron emission tomography. Cancer 2005;104:2484–2491.CrossRefPubMedGoogle Scholar
  7. 7.
    Chou HH, Chang TC, Yen TC, Ng K-K, Hsueh S, Ma S-Y, Chang C-J, Huang H-J, Chao A, Wu T-I, Jung S-M, Wu Y-C, Lin C-T, Huang K-G, Lai C-H. Low value of [18F]-fluoro-2-deoxy-D-glucose positron emission tomography in primary staging of early-stage cervical cancer before radical hysterectomy. J Clin Oncol 2005;24:123–128.CrossRefGoogle Scholar
  8. 8.
    Sironi S, Buda A, Picchio M, Perego P, Moreni R, Pellegrino A, Colombo M, Mangioni C, Messa C, Fazio F. Lymph node metastasis in patients with clinical early-stage cervical cancer: detection with integrated FDG PET/CT. Radiology 2005;238:272–279.CrossRefPubMedGoogle Scholar
  9. 9.
    Lin LL, Mutic S, Low DA, LaForest R, Vicic M, Zoberi I, Miller T, Grigsby P. Adaptive brachytherapy treatment planning for cervical cancer using FDG-PET. Int J Radiat Oncol Biol Phys 2007;67:91–96.CrossRefPubMedGoogle Scholar
  10. 10.
    Sakuragi N. Up-to-date management of lymph node metastasis and the role of tailored lymphadenectomy in cervical cancer. Int J Clin Oncol 2007;12:165–175.CrossRefPubMedGoogle Scholar
  11. 11.
    Panici PB, Cutillo G, Angioli R. Modulation of surgery in early invasive cervical cancer. Crit Rev Oncol Hematol 2003;48:263–270.CrossRefPubMedGoogle Scholar
  12. 12.
    Miller TR, Grigsby PW. Measurement of tumor volume by PET to evaluate prognosis in patients with advanced cervical cancer treated by radiation therapy. Int J Radiat Oncol Biol Phys 2002;53:353–359.CrossRefPubMedGoogle Scholar
  13. 13.
    Kidd EA, Siegel BA, Dehdashti F, Grigsby PW. The standardized uptake value for F-18 fluorodeoxyglucose is a sensitive predictive biomarker for cervical cancer treatment response and survival. Cancer 2007;110:1738–1744.CrossRefPubMedGoogle Scholar
  14. 14.
    Grigsby PW, Siegel BA, Dehdashti F. Lymph node staging by positron emission tomography in patients with carcinoma of the cervix. J Clin Oncol 2001;19:3745–3749.PubMedGoogle Scholar
  15. 15.
    Chung HH, Jo H, Kang WJ, Kim JW, Park N-H, Song Y-S, Chung J-K, Kang S-B, Lee H-P. Clinical impact of integrated PET/CT on the management of suspected cervical cancer recurrence. Gynecol Oncol 2007;104:529–534.CrossRefPubMedGoogle Scholar
  16. 16.
    Yen TC, Lai CH, Ma SY, Huang K-G,  Huang H-J,  Hong J-H,  Hsueh S,  Lin W-J, Ng K-K, Chang T-C. Comparative benefits and limitations of (18)F-FDG PET and CT-MRI in documented or suspected recurrent cervical cancer. Eur J Nucl Med Mol Imaging 2006;33:1399–1407.CrossRefPubMedGoogle Scholar
  17. 17.
    Grigsby PW, Siegel BA, Dehdashti F, Rader J, Zoberi I. Posttherapy [18F] fluorodeoxyglucose positron emission tomography in carcinoma of the cervix: Response and outcome. J Clin Oncol 2004;22:2167–2171.CrossRefPubMedGoogle Scholar
  18. 18.
    Schwarz JK, Siegel BA, Dehdashti F, Grigsby PW. Association of posttherapy positron emission tomography with tumor response and survival in cervical carcinoma. JAMA 2007;298:2289–2295.CrossRefPubMedGoogle Scholar
  19. 19.
    Johnson RJ. Radiology in the management of ovarian cancer. Clin Radiol 1993;48:75–82.CrossRefPubMedGoogle Scholar
  20. 20.
    Lerman H, Metser U, Grisaru D, Fishman A, Lievshitz G, Even-Sapir E. Normal and abnormal 18F-FDG endometrial and ovarian uptake in pre- and postmenopausal patients: Assessment by PET/CT. J Nucl Med 2004;45:266–271.PubMedGoogle Scholar
  21. 21.
    Grab D, Flock F, Stohr I, Nüssle K, Rieber A, Fenchel S, Brambs H-J, Reske SN, Kreienberg R. Classification of asymptomatic adnexal masses by ultrasound, magnetic resonance imaging, and positron emission tomography. Gynecol Oncol 2000;77:454–459.CrossRefPubMedGoogle Scholar
  22. 22.
    Yoshida Y, Kurokawa T, Kawahara K, Tsuchida T, Okazawa H, Fujibayashi Y, Yonekura Y, Kotsuji F. Incremental benefits of FDG positron emission tomography over CT alone for the preoperative staging of ovarian cancer. AJR Am J Roentgenol 2004;182:227–233.PubMedGoogle Scholar
  23. 23.
    Castellucci P, Perrone AM, Picchio M, Ghi T, Farsad M, Nanni C, Messa C, Meriggiola M, Pelusi G, Al-Nahhas A, Rubello D, Fazio F, Fanti S. Diagnostic accuracy of 18F-FDG PET/CT in characterizing ovarian lesions and staging ovarian cancer: Correlation with transvaginal ultrasonography, computed tomography, and histology. Nucl Med Commun 2007;28:589–595.CrossRefPubMedGoogle Scholar
  24. 24.
    Chan JK, Cheung MK, Husain A, Teng NN, West D, Whittemore AS, Berek JS, Osann K. Patterns and progress in ovarian cancer over 14 years. Obstet Gynecol 2006;108:521–528.CrossRefPubMedGoogle Scholar
  25. 25.
    Chan YM, Ng TY, Ngan HY, Wong LC. Quality of life in women treated with neoadjuvant chemotherapy for advanced ovarian cancer: a prospective longitudinal study. Gynecol Oncol 2003;88:9–16.CrossRefPubMedGoogle Scholar
  26. 26.
    Avril N, Sassen S, Schmalfeldt B, Naehrig J, Rutke S, Weber WA, Werner M, Graeff H, Schwaiger M, Kuhn W. Prediction of response to neoadjuvant chemotherapy by sequential F-18-Fluorodeoxyglucose positron emission tomography in patients with advanced-stage ovarian cancer. J Clin Oncol 2005;23:7445–7453.CrossRefPubMedGoogle Scholar
  27. 27.
    Bristow RE, del Carmen MG, Pannu HK, Cohade C, Zahurak ML, Fishman E, Wahl RL, Montz FJ. Clinically occult recurrent ovarian cancer: Patient selection for secondary cytoreductive surgery using combined PET/CT. Gynecol Oncol 2003;90:519–528.CrossRefPubMedGoogle Scholar
  28. 28.
    Chung HH, Kang WJ, Kim JW, Park N-H,  Song Y-S, Chung J-K,  Kang S-B, Lee H-P. Role of [18F]FDG PET/CT in the assessment of suspected recurrent ovarian cancer: correlation with clinical or histological findings. Eur J Nucl Med Mol Imaging 2007;34:480–486.CrossRefPubMedGoogle Scholar
  29. 29.
    Simcock B, Neesham D, Quinn M, Drummond E, Milner A, Hicks RJ. The impact of PET/CT in the management of recurrent ovarian cancer. Gynecol Oncol 2006;103:271–276.CrossRefPubMedGoogle Scholar
  30. 30.
    Zhuang H, Yamamoto AJ, Sinha P, Pourdehnad M, Liu Y, Alavi A. Similar pelvic abnormalities on FDG positron emission tomography of different origins. Clin Nucl Med 2001;26:515–517.CrossRefPubMedGoogle Scholar
  31. 31.
    Lee WL, Liu RS, Yuan CC, Chao HT, Wang PH. Relationship between gonadotropin-releasing hormone agonist and myoma cellular activity: Preliminary findings on positron emission tomography. Fertil Steril 2001;75:638–639.CrossRefPubMedGoogle Scholar
  32. 32.
    Horowitz NS, Dehdashti F, Herzog TJ, Rader JS, Powell MA, Gibb RK, Grigsby PW, Siegel BA, Mutch DG. Prospective evaluation of FDG-PET for detecting pelvic and para-aortic lymph node metastasis in uterine corpus cancer. Gynecol Oncol 2004;95:546–551.CrossRefPubMedGoogle Scholar
  33. 33.
    Suzuki R, Miyagi E, Takahashi N, Sukegawa A, Suzuki A, Koike I, Sugiura K, Okamoto N, Inoue T, Hirahara F. Validity of positron emission tomography using fluoro-2-deoxyglucose for the preoperative evaluation of endometrial cancer. Int J Gynecol Cancer 2007;17:890–896.CrossRefPubMedGoogle Scholar
  34. 34.
    Belhocine T, De Barsy C, Hustinx R, Willems-Foidart J. Usefulness of (18)F-FDG PET in the post-therapy surveillance of endometrial carcinoma. Eur J Nucl Med Mol Imaging 2002;29:1132–1139.CrossRefPubMedGoogle Scholar
  35. 35.
    Saga T, Higashi T, Ishimori T, Marcelo M. Yuji N, Takahiro M, Toru F, Kaori T, Shigeo Y, Toshihiro H, Masato K, Shingo F, Junji K. Clinical value of FDG-PET in the follow up of post-operative patients with endometrial cancer. Ann Nucl Med 2003;17:197–203.CrossRefPubMedGoogle Scholar
  36. 36.
    Podoloff DA, Ball DW, Ben-Josef E, Benson AB, Cohen SJ, Coleman RE, Delbeke D, Ho M, Ilson DH, Kalemkerian GP, Lee RJ, Loeffler JS, Macapinlac HA, Morgan RJ, Siegel BA, Singhal S, Tyler DS, Wong RJ. NCCN Task Force: Clinical Utility of PET in a Variety of Tumor Types Task Force. J Natl Compr Canc Netw 2009;7 Suppl 2:S1–S23. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp Google Scholar
  37. 37.
    Ferrandina G, Legge F, Salutari V, Paglia A, Testa A, Scambia G. Impact of pattern of recurrence on clinical outcome of ovarian cancer patients: Clinical considerations. Eur J Cancer 2006;42:2296–2302.CrossRefPubMedGoogle Scholar
  38. 38.
    Sartori E, Pasinetti B, Carrara L, Gambino A, Odicino F, Pecorelli S. Pattern of failure and value of follow-up procedures in endometrial and cervical cancer patients. Gynecol Oncol 2007;107:S241–247.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Mallinckrodt Institute of RadiologyWashington University School of MedicineSt. LouisUSA
  2. 2.Division of Nuclear MedicineEdward Mallinckrodt Institute of Radiology and the Alvin J. Siteman Cancer Center Washington University School of MedicineSaint LouisUSA

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