Abstract
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Objectives The aim of this study was to evaluate whether the corrected whole body standard uptake ratio (CUR) in metastatic focus has a linear relationship with a serum squamous cell carcinoma (SCC) antigen level in patients with recurrent cervical cancer.
Methods Fifty-four patients (mean age, 52.1 ± 12) who had underwent radical hysterectomy for cervical cancer January 2007 to February 2011 were enrolled. A one hour and two hour whole body 18F-FDG-PET/CT (brain to foot) (Gemini TF PET/CT, Philips Medical Systems) was performed after injection of 370-555 MBq of 18F-FDG. The serum SCC level was also measured. The time interval between the performance of PET/CT and sampling for serum SCC level was ± 5.6 days. The maximum standard uptake value (SUVmax) was obtained from the regular region of interest in metastatic focus showing the highest intensity. The histopathological examination was performed for recurrence assessment.
Results Of 54 patients, recurrence was histologically confirmed in 30 patients, and the remaining 24 were free of recurrence. When the CUR cut-off value in metastatic focus was set at 57.9 by receiver operating curve analysis, the sensitivity and specificity for the diagnosis of recurrence were 87.1% and 76.5%, respectively. The median serum SCC antigen level between recurrence group and non-recurrence group were significantly different (10.45 ug/L versus 2.98 ug/L; P<0.0001). The CUR measured in metastatic focus demonstrated a positive correlation with serum SCC antigen level (correlation coefficient, r=0.8137, P<0.0001).
Conclusions The CUR of metastatic focuses in patients with suspicious recurrent cervical cancer calculated from the dual-phase 18F-FDG-PET/CT might be used as an indirect diagnostic tool for disease recurrence.