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Diagnostic Applications of Nuclear Medicine: Uterine Cancers

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Nuclear Oncology

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Abstract

Cervical and uterine malignancies are a significant health issue for women worldwide. Uterine cancers are the most common gynecological cancers, although ovarian cancers have the highest mortality. The primary modalities for anatomic imaging are ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI). These imaging tools are used for the diagnosis, staging, and posttherapy follow-up for detection of recurrent disease; however, they lack biologic information. Positron emission tomography (PET) with [18F]fluoro-2-deoxy-D-glucose ([18F]FDG) imaging plays a critical role in the evaluation of cervical and uterine malignancies. A number of studies have established the role of [18F]FDG PET in the staging and prognosis of advanced cervical cancer. PET/MRI scanners with newer technology are available and in future may be the mainstay in assessment of gynecologic malignancies.

Radionuclide lymphoscintigraphy is an established technique for sentinel lymph node (SNL) map** in vulvar cancer. For cervical and endometrial cancer, it can help prevent morbidities that follow lymphadenectomies and there is convincing evidence that SLN map** can be useful in early-stage disease.

In this chapter, we discuss the role of nuclear imaging, especially [18F]FDG PET scanning, and summarize the initial experiences with PET/MRI in cervical and uterine cancers; we also discuss the use of lymphoscintigraphy in gynecological cancers.

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Abbreviations

[18F]FDG:

2-Deoxy-2-[18F]fluoro-d-glucose

18F-FMISO:

18F-fluoromisonidazole, 1-fluoro-3-(2-nitroimidazol-1-yl)-propan-2-ol

ADC:

Apparent diffusion coefficient, a parameter of magnetic resonance imaging

AJCC:

American Joint Committee on Cancer

ceCT:

Contrast-enhanced computed tomography

CI:

Confidence interval

CIN:

Cervical intraepithelial neoplasia

CT:

X-ray computed tomogaphy

DES:

Diethylstilbestrol

EC:

Endometrial cancer

FDA:

United States Food and Drug Administration

FIGO:

International Federation of Obstetrics and Gynecology

GLUT:

Glucose transporter family

HIV:

Human immunodeficiency virus

HK:

Hexokinase

HPV:

Human papilloma virus

IMRT:

Intensity-modulated radiation therapy

IVP:

Intravenous pyelography

LACC:

Locally advanced cervical cancer

LSG:

Lymphoscintigraphy

M:

Metastasis status according to the AJCC/UICC TNM staging system

MIP:

Maximum intensity projection

MRI:

Magnetic resonance imaging

MTV:

Metabolic tumor volume

N:

Lymph node status according to the AJCC/UICC TNM staging system

NPV:

Negative predictive value

OS:

Overall survival

PALN:

Para-aortic lymph nodes

PET:

Positron emission tomography

PET/CT:

Positron emission tomography/Computed tomography

PET/MRI:

Positron emission tomography/Magnetic resonance imaging

PFS:

Progression-free survival

PLN:

Pelvic lymph nodes

PPV:

Positive predictive value

SCC:

Squamous cell carcinoma

SNL:

Sentinel lymph node

SPECT:

Single-photon emission computed tomography

SPECT/CT:

Single-photon emission computed tomography/Computed tomography

SUV:

Standardized uptake value

SUVmax :

Standardized uptake value at point of maximum

T:

Tumor status according to the AJCC/UICC TNM staging system

TLG:

Total lesion glycolysis

UICC:

Union Internationale Contre le Cancer (International Union Against Cancer)

US:

Ultrasonography

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Authors and Affiliations

  1. Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA

    Neeta Pandit-Taskar, Sonia Mahajan & Weining Ma

  2. Department of Radiology, Weill Cornell Medical College, New York, NY, USA

    Neeta Pandit-Taskar

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  1. Neeta Pandit-Taskar
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  2. Sonia Mahajan
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  3. Weining Ma
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Correspondence to Neeta Pandit-Taskar .

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Editors and Affiliations

  1. Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA

    H. William Strauss

  2. University of Pisa, Regional Center of Nuclear Medicine, Pisa, Italy

    Giuliano Mariani

  3. University of Pisa, Regional Center of Nuclear Medicine, Pisa, Italy

    Duccio Volterrani

  4. Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA

    Steven M. Larson

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Pandit-Taskar, N., Mahajan, S., Ma, W. (2017). Diagnostic Applications of Nuclear Medicine: Uterine Cancers. In: Strauss, H., Mariani, G., Volterrani, D., Larson, S. (eds) Nuclear Oncology. Springer, Cham. https://doi.org/10.1007/978-3-319-26236-9_45

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