Accuracy of 18F-FDG PET-CT for detection of recurrence in patients with endometrial carcinoma: Comparison with conventional imaging

Objectives The aim of the present study was to compare the diagnostic efficacy of F18-FDG PET-CT with conventional imaging (CI) for the detection of recurrence in previously treated patients of endometrial carcinoma.

Methods A total of 20 endometrial carcinoma patients previously treated by surgery (20)/ radiotherapy (7)/or chemotherapy (4) and having suspected recurrence were analysed retrospectively. The mean age was 56.4±10 years (range: 38-77). Four patients were premenopausal and 16 were postmenopausal. All patients underwent F18-FDG PET-CT for recurrence suspected clinically and/or on CI. F18-FDG PET-CT studies were evaluated by two nuclear medicine physicians. Results of F18-FDG PET-CT were compared with CI (ultrasound/ CT/ MRI). Final diagnosis of recurrence was made by biopsy and/or clinical/imaging follow up.

Results Of 20 patients, 15 were found to have recurrence based on biopsy and/or clinical/imaging follow up. F18-FDG PET-CT was positive in 86.6% (13/15) of these patients; while CI was positive in 80% (12/15). Five patients did not have recurrence. The sensitivity, specificity, PPV and NPV of F18-FDG PET-CT for detecting recurrence were 81.3%, 75%, 92.6%, 50% and that of CI were 80%, 60%, 85.7% and 50%, respectively. Both F18-FDG PET-CT and CI detected local recurrence in 8 patients (p 1.00). Most common site of distant metastasis on F18-FDG PET-CT was lymph node (8/15) followed by lung (5/15), liver (2/15), bone (2/15) and least common was adrenal gland (1/15). CI detected only 12/18 (66.6 %) of metastatic lesions detected on F18-FDG PET-CT. F18-FDG PET-CT detected significantly more lymph nodal, liver and lung metastasis compared to CI (p 0.044).

Conclusions F18-FDG PET-CT plays an important role in detecting recurrent disease in patients with endometrial cancer. PET-CT performs better than CI especially for detection of recurrence in node, lung and liver metastasis