PET/CT Best for Ovarian, Cervical Cancer Management

Laurie Barclay, MD

June 20, 2002

June 20, 2002 — Combined positron emission tomography/computed tomography (PET/CT) is more accurate than CT or ultrasound alone for staging and restaging of ovarian and cervical cancer, according to results of two studies presented on June 18 at the Society of Nuclear Medicine annual meeting in Los Angeles, California. Because the combined scan often detects occult lesions missed by CT alone, the results often change management.

"We found the combined PET/CT is a very important machine for staging and restaging patients with these types of cancers, [which] are notoriously difficult to pinpoint in the body because they are in relatively small areas packed with many different types of tissue," lead author Todd Blodgett, MD, from the University of Pittsburgh School of Medicine, says in a news release. "It is difficult, using conventional CT or ultrasound, to find all the lesions or to identify their precise locations."

In this study, in 15 women with ovarian carcinoma, PET/CT identified lesions that CT or ultrasound did not in 12 cases (80%). In 11 of these 12 cases, detection of the additional lesions altered management.

In a second study, Blodgett's group studied 11 patients with cervical carcinoma. Combined PET/CT identified additional lesions missed by CT and ultrasound alone in five patients (45%), all of whom had their treatment changed to address the additional areas of involvement.

"These results, though gained from a relatively small sample, are significant because they show the current standard of using CT or ultrasound as the primary method for finding lesions may not be the best," says David Townsend, PhD, a senior PET physicist at the University of Pittsburgh, Pennsylvania, who jointly developed the PET/CT with Ronald Nutt, PhD, president of CPS Innovations in Knoxville, Tennessee. "The tools most doctors rely on for this very important function may be missing a significant number of lesions."

Due to limited availability of the combined PET/CT scanners — it is currently in only about 70 hospitals in the United States, Europe, and Asia — these results will probably not lead to an immediate change in diagnostic standards. However, Townsend says that the emphasis of PET on metabolic as well as anatomical imaging is a very promising development for difficult-to-track cancers, including ovarian, cervical, head and neck, and lung.

SNM Annual Meeting June 18, 2002.

Reviewed by Gary D. Vogin, MD

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