Objective. To assess the role of hybrid PET/CT in the evaluation of patients with cervical cancer. Methods. 75 patients divided into 3 groups. Group 1 consisted of 16 patients prior to radical surgery. Group 2 consisted of 31 patients prior to pelvic radiotherapy. Group 3 had 28 patients who underwent the examination secondary to suspected recurrent disease. Whole body PET and CT were performed respectively on the same device 1 h after injection of 10 mCi FDG. PET/CT results were correlated to histological, radiological and clinical follow- up data. Only women with >6 months follow- up were included. Results. In 33 patients, pathohistological ex aminations for extra cervical lesions were obtained. Correlation with PET/CT examination revealed levels of sensitivity (60% ), specificity (94% ), positive (90% ) and negative predictive values (74% ). The examination indicated 21 patients with extra pelvic and/or metastatic disease. The follow- up data of this group revealed that 20 patients either died or were alive with active disease, and only one patient was in clinical remission. PET/CT yielded an improved diagnosis for both PET and CT in 43% of the cases by providing better localization and definition of abnormal FDG uptake. Conclusions. Hybrid PET/CT was found to be of value for detection of cervical cancer metastases, decision- making and planning of irradiation therapy. Using this modality may reduce unnecessary surgical interventions, help modify radiation fields and change therapeutic approaches. Detection of advanced diseases on PET/CT correlates with poor prognosis. However, this examination is less accurate in detecting microscopic diseases and lesions smaller than 1.5 cm.
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