Somatostatin receptor PET/CT is clinically not suitable for diagnosis of adenomyosis uteri

Objectives Recently, there were some publications on somatostatin receptor (SR) expression in adenomyosis uteri suggesting SR imaging as a potential diagnostic tool in this so-far unsatisfactory diagnostic setting. The aim of our study was to investigate the diagnostic value of SR-PET/CT in women with adenomyosis uteri.

Methods We retrospectively analyzed 34 women with a median age of 46 years (range, 22-72 years) who underwent SR-PET/CT and magnetic resonance imaging (MRI) at our institution between 01/2010 and 02/2013. Standard criteria of MRI defined adenomyosis uteri and were used as the gold standard in synopsis with clinical symptoms diagnosed by two physicians and one gynecologist. Two observers - blinded to the MRI findings- reviewed the SR-PET/CT for adenomyosis uteri in consensus. Visual SR-PET/CT analysis was performed to identify pathological tracer uptake as an indicator of adenomyosis uteri. For semiquantitative analysis the observers determined the maximum standard uptake value (SUVmax) of the uterus.

Results Ten of 34 (29.4%) women had clinical symptoms and showed clearly adenomyosis uteri by MRI; none of them (0%) had pathological tracer uptake in the visual SR-PET/CT analysis. SUVmax of the whole uterus in women with and without adenomyosis uteri did not differ significantly (p= 0.118).

Conclusions Visual and semiquantitative SR-PET/CT analysis does not allow detecting adenomyosis uteri.