Skip to main content
Log in

Clinical value of FDG-PET for preoperative evaluation of endometrial cancer

  • Original Article
  • Published:
Annals of Nuclear Medicine Aims and scope Submit manuscript

Abstract

Objective

Whole body positron emission tomography (PET) with F-18 fluorodeoxyglucose (FDG) has been widely used in various malignancies, but the clinical value of FDG-PET for endometrial cancer has not been fully investigated. The purpose of this study was to evaluate the usefulness of FDG-PET for preoperative evaluation of endometrial cancer.

Methods

Forty female patients suspected of having endometrial cancer were included in this study. All patients underwent an FDG-PET or PET/CT scan, and images were interpreted visually. The diagnostic performance in detecting the primary tumor, regional nodal status, and distant metastasis was determined. In addition, the usefulness of PET was assessed in terms of additional information and clinical impact for therapeutic management.

Results

Of 40 patients, 30 were histologically confirmed to have endometrial cancer. The patient-based sensitivity and specificity of FDG-PET for primary tumors were 83 and 100%, respectively, and 100 and 100%, respectively, for nodal metastases. There were 12 distant metastases in 6 patients and two second primary cancers in two patients, which were all accurately diagnosed by PET on a patient-basis. PET yielded 12 additional findings in 10 patients, and had a bearing on the therapeutic management of four patients, including one patient with recurrent breast cancer.

Conclusions

FDG-PET had a reasonably high diagnostic accuracy in endometrial cancer. Although the number of cases with clinical impact was limited, additional information by PET was obtained in one-third of the cases.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Manfredi R, Mirk P, Maresca G, Margariti PA, Testa A, Zannoni GF, et al. Local-regional staging of endometrial carcinoma: role of MR imaging in surgical planning. Radiology. 2004;231:372–8.

    Article  PubMed  Google Scholar 

  2. Koyama T, Tamai K, Togashi K. Staging of carcinoma of the uterine cervix and endometrium. Eur Radiol. 2007;17:2009–19.

    Article  PubMed  Google Scholar 

  3. Rockall AG, Meroni R, Sohaib SA, Reynolds K, Alexander-Sefre F, Shepherd JH, et al. Evaluation of endometrial carcinoma on magnetic resonance imaging. Int J Gynecol Cancer. 2007;17:188–96.

    Article  PubMed  CAS  Google Scholar 

  4. Connor JP, Andrews JI, Anderson B, Buller RE. Computed tomography in endometrial carcinoma. Obstet Gynecol. 2000;95:692–6.

    Article  PubMed  CAS  Google Scholar 

  5. Horowitz NS, Dehdashti F, Herzog TJ, Rader JS, Powell MA, Gibb RK, et al. Prospective evaluation of FDG-PET for detecting pelvic and para-aortic lymph node metastasis in uterine corpus cancer. Gynecol Oncol. 2004;95:546–51.

    Article  PubMed  Google Scholar 

  6. Suzuki R, Miyagi E, Takahashi N, Sukegawa A, Suzuki A, Koike I, et al. Validity of positron emission tomography using fluoro-2-deoxyglucose for the preoperative evaluation of endometrial cancer. Int J Gynecol Cancer. 2007;17:890–6.

    Article  PubMed  CAS  Google Scholar 

  7. Kitajima K, Murakami K, Yamasaki E, Fukasawa I, Inaba N, Kaji Y, et al. Accuracy of 18F-FDG PET/CT in detecting pelvic and paraaortic lymph node metastasis in patients with endometrial cancer. Am J Roentgenol. 2008;190:1652–8.

    Article  Google Scholar 

  8. Saga T, Higashi T, Ishimori T, Mamede M, Nakamoto Y, Mukai T, et al. Clinical value of FDG-PET in the follow up of post-operative patients with endometrial cancer. Ann Nucl Med. 2003;17:197–203.

    Article  PubMed  Google Scholar 

  9. Kitajima K, Murakami K, Yamasaki E, Hagiwara S, Fukasawa I, Inaba N, et al. Performance of FDG-PET/CT in the diagnosis of recurrent endometrial cancer. Ann Nucl Med. 2008;22:103–9.

    Article  PubMed  Google Scholar 

  10. Ayhan A, Tuncer R, Tuncer ZS, Yüce K, Küçükali T. Correlation between clinical and histopathologic risk factors and lymph node metastases in early endometrial cancer (a multivariate analysis of 183 cases). Int J Gynecol Cancer. 1994;4:306–9.

    Article  PubMed  Google Scholar 

  11. Jobo T, Sato R, Arai T, Tamura T, Watanabe J, Kuramoto H. Lymph node pathway in the spread of endometrial carcinoma. Eur J Gynecol Oncol. 2005;26:167–9.

    CAS  Google Scholar 

  12. Bristow RE, Zahurak ML, Alexander CJ, Zellars RC, Montz FJ. FIGO stage IIIC endometrial carcinoma: resection of macroscopic nodal disease and other determinants of survival. Int J Gynecol Cancer. 2003;13:664–72.

    Article  PubMed  CAS  Google Scholar 

  13. Candiani GB, Belloni C, Maggi R, Colombo G, Frigoli A, Carinelli SG. Evaluation of different surgical approaches in the treatment of endometrial cancer at FIGO stage I. Gynecol Oncol. 1990;37:6–8.

    Article  PubMed  CAS  Google Scholar 

  14. Bar-Am A, Ron IG, Kuperminc M, Gal I, Jaffa A, Kovner F, et al. The role of routine pelvic lymph node sampling in patients with stage I endometrial carcinoma: second thoughts. Acta Obstet Gynecol Scand. 1998;77:347–50.

    Article  PubMed  CAS  Google Scholar 

  15. Mariani A, Webb MJ, Keeney GL, Haddock MG, Calori G, Podratz KC. Low-risk corpus cancer: is lymphadenectomy or radiotherapy necessary? Am J Obstet Gynecol. 2000;182:1506–19.

    Article  PubMed  CAS  Google Scholar 

  16. Cragun JM, Havrilesky LJ, Calingaert B, Synan I, Secord AA, Soper JT, et al. Retrospective analysis of selective lymphadenectomy in apparent early-stage endometrial cancer. J Clin Oncol. 2005;23:3668–75.

    Article  PubMed  Google Scholar 

  17. Kasamatsu T, Onda T, Katsumata N, Sawada M, Yamada T, Tsunematsu R, et al. Prognostic significance of positive peritoneal cytology in endometrial carcinoma confined to the uterus. Br J Cancer. 2003;88:245–50.

    Article  PubMed  CAS  Google Scholar 

  18. Ebina Y, Hareyama H, Sakuragh N, Yamamoto R, Furuya M, Sogame M, et al. Peritoneal cytology and its prognostic value in endometrial carcinoma. Int Surg. 1997;82:244–8.

    PubMed  CAS  Google Scholar 

  19. Creasman W. Revised FIGO staging for carcinoma of the endometrium. Int J Gynaecol Obstet. 2009;105:109.

    Article  PubMed  Google Scholar 

  20. Goff BA, Goodman A, Muntz HG, Fuller AF Jr, Nikrui N, Rice LW. Surgical stage IV endometrial carcinoma: a study of 47 cases. Gynecol Oncol. 1994;52:237–40.

    Article  PubMed  CAS  Google Scholar 

  21. Chi DS, Welshinger M, Venkatraman ES, Barakat RR. The role of surgical cytoreduction in Stage IV endometrial carcinoma. Gynecol Oncol. 1997;67:56–60.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tsuyoshi Suga.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Suga, T., Nakamoto, Y., Saga, T. et al. Clinical value of FDG-PET for preoperative evaluation of endometrial cancer. Ann Nucl Med 25, 269–275 (2011). https://doi.org/10.1007/s12149-011-0474-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12149-011-0474-2

Keywords

Navigation