PET-imaging in tumors of the reproductive trac

There is increasing evidence that metabolic imaging with positron-emission tomography (PET) using fluor-18 labeled fluorodeoxyglucose (18F FDG) is highly accurate for in vivo detection of a variety of malignancies. This quality gives FDG-PET an important role in the detection of malignant tumors and their metastases as well as for differentiation of tumors of unknown etiology. In the male and female reproductive tract, whole body imaging with FDG-PET is in particular capable of visualizing lymph-node and distant metastases before these changes become apparent on conventional cross-sectional imaging modalities. According to the incidence of tumors in the reproductive tract, FDG-PET-imaging has been evaluated in prostate cancer, ovarian cancer, cervical and testicular cancer. The role of PET is discussed with respect to the current management of patients. The presented data indicate that FDG-PET is more accurate for lymph-node staging in cervical cancer and testicular cancer. In ovarian cancer, FDG-PET may be helpful for detection of tumor recurrence. The role of FDG-PET is questionable in prostate cancer, due to the low metabolic activity of this type of cancer. Carbon-11 labeled acetate and carbon-11 or fluor-18 labeled choline are more promising than FDG for detection of recurrence in prostate cancer. In all other tumors of the reproductive tract there is limited experience with PET for a final conclusion.