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Comparison of combined PET/CT and 18F-FDG PET only in cervical cancers

N. NagabhushanInstitute of Nuclear Medicine, andR. SyedInstitute of Nuclear Medicine, andS. GacinovicInstitute of Nuclear Medicine, andM. McCormarkDept of Oncology, Royal Free and University College Medical School, Middlesex Hospital, London, UKPeter J. EllInstitute of Nuclear Medicine, andJamshed BomanjiInstitute of Nuclear Medicine, and
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Aim: To assess anatomical localization of 18F-FDG uptake in primary cervical cancers with PET alone as compared to combined PET/CT. Method: A retrospective analysis of 18F-FDG studies in 15 patients (median=41, range=24–54 years) with cervical cancer was undertaken. Two-dimensional whole-body images were acquired using a GE discovery LS PET/CT scanner and data reconstructed using OSEM and CT based attenuation correction. SUVs were calculated for all FDG avid lesions. Three observers independently interpreted PET only images, and after a week, interpreted combined PET/CT images. 18F-FDG avidity at both the primary and non-primary sites was designated an anatomical territory and the degree of confidence for localization noted (0=exact region unknown, 1=probable, 2=definite). Change in confidence was calculated using the above scoring system and expressed as a percentage. Results: Of the 15 patients, FDG PET only identified 14 primary lesions (SUVmax=8.14) and 20 non-primary sites (SUVmax=6.9). Combined PET/CT identified all 15 primary lesions and 20 non-primary sites. Anatomical localization with FDG PET only was correct in 4/9 primary and 8/20 non-primary sites. Combined PET/CT correctly identified anatomical sites in all FDG avid lesions. Conclusion: 18F-FDG PET/CT, in comparison with 18F-FDG PET only, improves confidence of localizing of 18F-FDG avid sites by 59% in primary and 78% in non-primary sites.

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