Utility of Fluorine-18-fluorodeoxyglucose PET/CT in Uterine sarcoma patients.

Introduction: In comparison to leiomyoma, uterine sarcomas are rare mesenchymal malignant tumors with a high risk of recurrence and a poor prognosis. There are no optimum imaging approaches for postoperative imaging that have been established yet. The role of 18F-FDG PET/CT in post-surgical uterine sarcoma patients is being investigated in this study.

Methods: We retrospectively included the data of 18F-FDG PET/CT scans performed in 23 uterine sarcoma patients. An experienced nuclear medicine physician examined the scan as a single integrated imaging modality. A focal anomaly with SUVmax greater than liver SUVavg was defined as a positive lesion on FDG-PET/CT.

Results: The median age of the patients was 44 years (Interquartile range: 39-62 years). Histopathology showed undifferentiated uterine sarcoma in 2 patients, endometrial stromal sarcoma in 9 patients, and leiomyosarcoma in 12 patients. The indication was; baseline scan-2, residual disease work up-12 and, recurrence-9. Out of 23 patients, 14 were positive and 9 were negative for the metabolically abnormal lesion on PET/CT. Distant metastasis was present in 4 patients, lung and bone were the most common sites. Regional lymph node metastasis was present in 7 patients, while 3 had the local disease. Bone metastasis was found in 3 patients with median SUVmax 11.46. Multiple lung nodules were found in 4 patients with median SUVmax 5.85 (IQR: 1.9-15.2).

Conclusions: ¹⁸F-FDG PET/CT as a single integrated modality can be useful for the evaluation of initial and post therapy surveillance of uterine sarcoma.