Application value of 18F-FDG PETCT imaging in the clinical initial diagnosis and follow-up of primary lesions of cervical cancer

18F-FDG PET/CT成像在宫颈癌原发病灶临床初步诊断和随访中的应用价值

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Abstract

BACKGROUND: Cervical cancer is a common malignant tumor in gynecology with a high death rate. his study aims to analyze the application value of 18F-fluorodeoxyglucose imaging examination (18F-FDG PETCT) imaging in the initial clinical diagnosis and follow-up examination of cervical cancer. METHODS: The clinical data of 71 patients with cervical lesions who were admitted to our hospital from March 2017 to March 2019 were retrospectively collected all patients underwent 18F-FDG PETCT examination. The results of the pathological examination were a benchmark to calculate the sensitivity, specificity, and accuracy of 18F-FDG PETCT imaging in the diagnosis of primary lesions of cervical cancer and the diagnosis of postoperative recurrence, residual, and metastasis. RESULTS: There were 39 patients initially suspected, and 30 cases were diagnosed as cervical cancer by pathological examination, including 22 cases with squamous cell carcinoma, 4 cases with adenocarcinoma, 3 cases with carcinoma in situ, and 1 case with adenosquamous carcinoma. The maximum standard uptake (SUVmax) value was (10.36±5.22), and the patient's lesions showed different degrees of increase of 18F-FDG metabolism. The necrotic area in the patient's lesion showed reduced/defect metabolism. The sensitivity of 18F-FDG PETCT imaging in the diagnosis of primary lesions of cervical cancer was 86.66%, specificity was 44.44%, and accuracy was 76.92%. In the 32 cases followed up for monitoring after the operation, 16 cases showed recurrence, metastasis, residual and other conditions, and 7 cases showed local recurrence/metastasis. 18F-FDG PETCT images showed: abnormal widening of the cervix, stump nodules/mass in the vagina, and rectal and bladder infiltration. All patients with local recurrence were treated with local tissue biopsy or surgical resection under 18F-FDG PETCT image localization. The diagnostic sensitivity, specificity and diagnostic coincidence rate of 18F-FDG PETCT imaging for postoperative follow-up of cervical cancer patients were 100%, 75.00% and 87.50%, respectively. CONCLUSIONS: For patients with cervical cancer who are initially diagnosed or followed up, they can all be tested by 18F-FDG PETCT imaging, which can provide a reference for the formulation of diagnosis and treatment plan and the evaluation of prognosis.

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