18F-Fluorodesoxyglucose-Positron-Emission-Tomography (18F-FDG-PET) is a novel imaging modality for
malignancies. This study was initiated to define the efficiency of PET in detecting and characterizing metabolically the primaries and in preoperatively assessing of lymphonodal
metastases of
cervical cancer. 15 patients with histologically proven cervical
carcinoma were studied with 18F-FDG-PET regarding 18F-FDG-uptake of primary
tumor and evidence as well as extent of lymphonodal
metastases. 18F-FDG-PET and histopathological results were compared after radical
hysterectomy with pelvic and supplementary in 7 cases paraaortal
lymphadenectomy. All primary tumours showed
18F-FDG accumulation and had a mean maximal standardized uptake value (SUV) of 8.0 +/- 5.3. 3/6
lymph node metastases were obtained with 18F-FDG-PET.
Micrometastases (size of
metastasis < or = 0.2 cm) were present in 2 patients with false negative PET results. Regarding the subgroup with paraaortal
lymph node dissection, PET detected one patient with
metastases, the other one had
micrometastasis, while
metastasis was not observed by PET. The accuracy of PET is 73% for assessment of pelvic lymph nodes and 86% for assessment of paraaortal lymph nodes. In conclusion
18F-FDG accumulates reliably in primaries of
cervical cancer. Regarding assessment of
lymph node metastases PET seems to be of potential use, offering metabolic information independent of the size of metastatic lymph nodes. An improvement of accuracy can be expected if combined evaluation of morphologic and metabolic images is performed.