Performance of FDG PET/CT in the initial staging of endometrial cancer

Objectives The aim of this retrospective analysis was to assess the diagnostic performance of FDG PET/CT in the pre-treatment staging of patients with known or suspected endometrial cancer.

Methods Our PET/CT database was queried using “uterine” and “endometrial” as key words. These scans were performed from 2003 to 2012. Twenty-six PET/CT scans for pre-treatment staging of endometrial cancer were identified. Each scan report impression was assessed on a 5-point scale: 1 - disease free, 2 - disease unlikely, 3 - equivocal disease status, 4 - disease possible, 5 - disease probable. The PET/CT results were then compared with pathology results which were available for every case.

Results Of the 26 PET/CT studies, 22 (85%) studies were positive (score of 3, 4, or 5), whereas 4 (15%) were negative (score of 1 or 2). A score of 3, 4, or 5 was considered positive based on ROC analysis. Included in this group were 10 confirmed cases of metastatic endometrial cancer identified on PET/CT. The predictive value of a positive PET/CT in the metastatic subgroup was 100%.

Conclusions FDG PET/CT imaging appears sensitive and has a high positive predictive value for metastatic disease.