FDG PET-CT in gynecologic oncology: Literature and pictorial review

Learning Objectives To collect and appraise published guidelines, systematic reviews, meta-analyses and literature reviews examining the role of FDG PET-CT in the diagnosis, staging, and follow up of gynecological malignancies. A systematic search of the MEDLINE database for guidelines, systematic reviews, meta-analyses and literature reviews published in French, English or Spanish since 1990. Defined key words were used for PET-CT and gynecologic malignancies and cross-referenced using Boolean operators. Key studies were appraised for study design, size and included populations. Most of the published literature was composed of small retrospective studies examining the role of PET rather than PET-CT. There is some evidence that FDG PET-CT changes the staging and management in a significant percentage of patients with cervical cancer. Evidence also seems to support its role in cervical, ovarian and endometrial cancers for post-treatment assessment, assessment of recurrence and in the context of normal CT and MRI but abnormal tumor markers.

Summary: There is a paucity of prospective studies examining the role of FDG PET-CT in gynecologic oncology. However, there seems to be some evidence supporting its role in the staging of cervical cancer, as well as the follow-up of cervical, ovarian and endometrial cancer.