The prognostic value of PET and PET/CT in cervical cancer

Cervical cancer ranks among the top three cancer diagnoses in women worldwide. In the United States, the SEER Cancer Statistics Review identified cervical cancer as the third leading cause (following childhood cancers and testicular cancer) of average years of life lost per person dying of cancer for all races and both genders. Approximately one-third of cervical cancer patients develop disease recurrence and the majority of these recurrences occur within the first 2 years after completion of therapy. Predictors of disease recurrence include stage and lymph node status at the time of initial diagnosis. The initial diagnosis and staging of cervical cancer has traditionally been achieved by history and physical examination and by use of selected imaging studies. Accurate staging is important both for selecting appropriate therapy and for prognosis. Computed tomography (CT) has been the most widely used imaging method for assessment of nodal involvement and detection of distant metastatic disease. Positron emission tomography (PET) has become an established imaging tool for cervical cancer. The functional information about regional glucose metabolism provided by fluorodeoxyglucose (FDG)-PET provides for greater sensitivity and specificity in most cancer imaging applications by comparison with CT and other anatomic imaging methods. PET is superior to conventional imaging modalities for evaluating patients with cervical cancer.