Metabolic monitoring of advanced uterine cervical cancer neoadjuvant chemotherapy by using [F-18]-Fluorodeoxyglucose positron emission tomography: preliminary results in three patients

• Published in: Gynecologic oncology 2004-12, Vol.95 (3), p.597-602
• Main Authors: Yoshida, Yoshio, Kurokawa, Tetsuji, Kawahara, Kazumi, Yagihara, Akira, Tsuchida, Tatsuro, Okazawa, Hidehiko, Fujibayashi, Yasuhisa, Yonekura, Yoshiharu, Kotsuji, Fumikazu
• Format: Article
• Language: English
• Subjects: Aged; Cervical cancer; FDG-PET for monitoring treatment response; Female; Fluorodeoxyglucose F18 - pharmacokinetics; Humans; Middle Aged; Neoadjuvant Therapy; Positron-Emission Tomography; Prospective Studies; Radiopharmaceuticals - pharmacokinetics; Uterine Cervical Neoplasms - diagnostic imaging; Uterine Cervical Neoplasms - drug therapy; Uterine Cervical Neoplasms - metabolism; Uterine Cervical Neoplasms - surgery
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1016/j.ygyno.2004.08.037

The aim of this report is to describe the potential clinical utility of tracer [F-18]-Fluorodeoxyglucose (FDG) uptake, quantitated as a standardized uptake value (SUV) by positron emission tomography (PET), to evaluate treatment response to neoadjuvant chemotherapy (NAC) in advanced uterine cervical cancer. We briefly describe the clinical courses of three women with advanced cervical cancer who were treated with neoadjuvant chemotherapy (NAC) prior to radical hysterectomy and who were analyzed for correlation with the decrease in tumor volume by magnetic resonance imaging (MRI), in SUV by FDG-PET, and by histologic response. In these individuals, tumor volume and SUV were decreased by NAC. The decrease in SUV by FDG-PET was better correlated to histologic response for NAC than MRI was in advanced cervical cancer. Measurement of SUV by FDG-PET has clinical utility in evaluating treatment response for NAC in advanced cervical cancer. Although work in this field is still in the early stages, this report demonstrates that SUV by FDG-PET has the potential to become the new standard for monitoring the treatment response of NAC in cervical cancer. This monitoring approach must be proven in a larger number of patients for both primary and secondary lesions and should be further explored in another gynecologic cancer.