Prognostic relevance of F-18 fluorodeoxyglucose positron emission tomography and computed tomography in molar pregnancy before evacuation.

Abstract

OBJECTIVE:

To assess prognostic significance of tumor metabolic activity of molar tissue by preevacuation F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) and computed tomography (CT) in patients clinically diagnosed with molar pregnancy.

STUDY DESIGN:

A total of 11 consecutive patients with clinical diagnosis of molar pregnancy before evacuation were enrolled. After evacuation of molar tissue, histopathologic findings and clinical follow-up were used as reference standards for the study.

RESULTS:

Six patients, 5 with complete and 1 with partial hydatidiform mole, had good outcome and normalization of beta-human chorionic gonadotropin (beta-hCG) levels within 5-7 weeks of evacuation. In the other 5 patients, serial measurements showed persistently and/or progressively elevated beta-hCG serum levels. These patients were treated with first-line single methotrexate or second-line etoposide, methotrexate, actinomycin D, cyclophosphamide, vincristine (EMA/CO) chemotherapy regimen. Standardized uptake value of molar tissue within the uterus in patients with persistently/progressively elevated beta-hCG levels was significantly higher than that in patients whose serum beta-hCG levels normalized after evacuation of molar tissue.

CONCLUSION:

Preliminary results suggest that F-18 FDG uptake within the uterus assessed by preevacuation PET/CT is predictive for probability of high-risk features of gestational trophoblastic disease or choriocarcinoma in patients with molar pregnancy.

• Authors: Ilknur Ak, Sinan Ozalp
• Journal: The Journal of reproductive medicine (J Reprod Med) Vol. 54 Issue 7 Pg. 441-6 (Jul 2009) ISSN: 0024-7758 [Print] United States
• PMID: 19691261 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antineoplastic Agents
• Chorionic Gonadotropin, beta Subunit, Human
• Fluorodeoxyglucose F18

Topics

• Adolescent
• Adult
• Antineoplastic Agents (therapeutic use)
• Chorionic Gonadotropin, beta Subunit, Human (blood)
• Female
• Fluorodeoxyglucose F18 (pharmacokinetics)
• Humans
• Hydatidiform Mole (diagnostic imaging, pathology, therapy)
• Middle Aged
• Positron-Emission Tomography (methods)
• Pregnancy
• Prognosis
• Uterine Neoplasms (diagnostic imaging, therapy)
• Uterus (diagnostic imaging, metabolism, pathology)
• Young Adult