FDG PET/CT delayed diuretic imaging technique for differentiating invasive pelvic cancer

A 72-year-old woman was diagnosed as having a International Federation of Gynecology and Obstetrics (FIGO II) stage cervical cancer with diffuse uterus corpus invasion without evidence of rectal or urinary bladder invasion as determined by endoscopic examinations. Recently, 2 sharp elevations of serum tumor marker squamous cell carcinoma (SCC) were noted while she was receiving radiation therapy. Therefore, a PET/CT scan was performed using fluorodeoxyglucose (FDG) to restage the cervical cancer. FDG-avid cervical tumor was shown to extend into the anterior uterine wall by use of a diuretic imaging technique, which lowered tracer activity in the bladder and improved visualization of lower pelvic structures, which otherwise might have been obscured by urine-FDG activity.