The Role of 18F-FDG PET in Assessing Therapy Response in Cancer of the Cervix and Ovaries
The Role of 18F-FDG PET in Assessing Therapy Response in Cancer of the Cervix and Ovaries
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DOI：
10.2967/jnumed.108.057257
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发表时间：
2009-05-01
影响因子：
9.3
通讯作者：
Delbeke, Dominique
中科院分区：
文献类型：
--
作者：
Schwarz, Julie K.;Grigsby, Perry W.;Delbeke, Dominique
对于局部晚期宫颈癌，目前的文献支持使用F-18-FDG PET评估同步放化疗完成后3个月的治疗反应。F-18-FDG PET可以为这些患者提供可靠的长期预后信息，将来可能用于指导其他治疗。研究领域包括使用F-18-FDG PET监测转移性和新辅助治疗背景下放疗和化疗期间的反应。对于卵巢肿块，F-18-FDG PET在检测交界性肿瘤方面的性能是有限的，而绝经前妇女正常卵巢中生理性F-18-FDG摄取的存在构成了另一个限制。初步数据表明，F-18-FDG PET和F-18-FDG PET/CT在初始分期方面的性能上级单独的CT，但两者在检测癌转移方面的敏感性有限。初步数据还表明，F-18-FDG PET可能是有前途的早期预测化疗反应和预测化疗完成后的反应。F-18-FDG PET和F-18-FDG PET/CT对疑似复发性卵巢癌患者的评估最有帮助，特别是当CA-125水平升高而CT结果正常或不确定时。PET和CT是互补的，PET/CT应在可用时使用。初步数据表明，将F-18-FDG PET/CT添加到这些患者的评估中，可以改变大约三分之一的管理，并通过准确识别将或不会从手术中受益的患者来降低整体治疗成本。
For locally advanced cervical cancer, the current literature supports the use of F-18-FDG PET for assessing treatment response 3 mo after the completion of concurrent chemoradiation. F-18-FDG PET can provide reliable long-term prognostic information for these patients and, in the future, may be used to guide additional therapy. Investigational areas include the use of F-18-FDG PET for monitoring response during radiotherapy and chemotherapy in the metastatic and neoadjuvant settings. For ovarian masses, the performance of F-18-FDG PET in the detection of borderline tumors is limited, and the presence of physiologic F-18-FDG uptake in normal ovaries of premenopausal women poses another limitation. Preliminary data suggest that the performance of F-18-FDG PET and F-18-FDG PET/CT is superior to that of CT alone in initial staging, but the sensitivity of both in the detection of carcinomatosis is limited. Preliminary data also suggest that F-18-FDG PET may be promising for early prediction of response to chemotherapy and for prediction of response after the completion of chemotherapy. F-18-FDG PET and F-18-FDG PET/CT are most helpful in the evaluation of patients with suspected recurrent ovarian carcinoma, especially when CA-125 levels are rising and CT findings are normal or equivocal. PET and CT are complementary, and PET/CT should be used when available. Preliminary data suggest that the addition of F-18-FDG PET/CT to the evaluation of these patients changes management in approximately a third and reduces overall treatment costs by accurately identifying patients who will or will not benefit from surgery.