FDG-PET Evaluation of Carcinoma of the Cervix

We performed fluorine-18 fluorodeoxyglucose-positron emission tomography (FDG-PET) in 23 women with carcinoma of the uterine cervix to determine sites of metastatic disease. PET results were compared with those of computed tomography (CT) or lymphangiography. Increased FDG uptake was seen in the primary tumor in 10 of 11 patients with newly diagnosed disease. Additional sites of FDG uptake were identified in pelvic lymph nodes in 8, in extrapelvic lymph nodes in 5, and at distant metastatic sites in 3. In 12 patients with suspected recurrent disease, FDG uptake was present in 11; the presence of tumor was confirmed by CT in 10 and by biopsy in 9. For both patient groups, FDG-PET demonstrated more sites of tumor metastasis than did conventional imaging studies. Our results suggest that FDG-PET is a sensitive method for detecting regional and distant metastasis in patients with cervical carcinoma and has the potential to replace conventional imaging studies and allow more rational treatment planning.