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Oncologic Imaging in Gynecologic Malignancies^*

Nuclear Medicine Service, Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York

¹⁸F-FDG PET imaging is underutilized in patients with gynecologic malignancies, and its role in current clinical practice has yet to be established. In cervical cancer, it has high sensitivity in detection of nodal disease. Its use is probably most suitable in patients with negative or ambiguous findings on other types of radiographic imaging. Data support its usefulness in asymptomatic cervical cancer patients with high tumor markers and negative conventional-imaging findings, although more data are needed to ascertain whether it has a positive impact on survival. Similarly, its role in monitoring response to therapies needs to be consolidated. In ovarian cancer, ¹⁸F-FDG PET holds promise in evaluation of recurrent or residual disease when other radiographic data are uncertain. In endometrial cancer, there are encouraging, although limited, data supporting the use of ¹⁸F-FDG PET in patients with recurrent disease. To reduce extensive lymph node dissection in patients and to decrease subsequent morbidity, investigators have advocated applying the sentinel node technique to patients with cervical, endometrial, or vulvar cancers. The overall results are encouraging for the use of LS in planning surgical procedures, although more data and larger planned studies are needed to establish clinical utility in the surgical management of patients with these malignancies.

Key Words: oncology • PET/CT • gynecologic malignancy • ovarian cancer

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