CT Chest Without IV Contrast For stage I patients who undergo nonfertility sparing treatment, the use of imaging for surveillance of cervical cancer in asymptomatic patients should be based on symptomatology and the degree of clinical concern such as clinical examination findings or pelvic, abdominal, or pulmonary symptoms [37]. For stage II to IV patients, CT of the chest may be used within 3 to 6 months after completion of therapy; however, NCCN guidelines indicate preference for PET/CT for this purpose [37]. Although the use of IV contrast material is preferred, the assessment may be performed without IV contrast. Imaging of the chest, abdomen, and pelvis is often concurrently performed. Follow-up of Invasive Cancer of the Cervix FDG-PET/CT Skull Base to Mid-Thigh FDG PET/CT is useful in the evaluation of local and distant recurrence even in asymptomatic patients, as well as in excluding metastatic disease in patients with pelvic recurrence amenable to radical surgery [5,37,54]. A meta- analysis including 18 studies and 762 patients showed that PET/CT had a pooled sensitivity and specificity of 92% (95% CI, 91%-94%) and 84% (95% CI, 74%-91%) and an area under the curve of 0.95 [70]. In another meta- analysis, the pooled sensitivity and specificity of PET/CT to detect local recurrence was 82% (95% CI, 72%-90%) and 98% (95% CI, 96%-99%), whereas that for distant metastasis was 87% (95% CI, 80%-92%) and 97% (95% CI, 96%-98%) [71]. In a retrospective study with 84 patients, higher MTV was associated with a higher rate of recurrence in patients with stage IIB to IVA cervical cancer [72]. Additional studies have indicated that metabolic parameters including SUVmax, MTV, and TLG may help predict outcomes including overall survival and therefore can influence the follow-up imaging strategy [43,46,73,74].
Pretreatment Evaluation and Follow up of Invasive Cancer of the Cervix. CT Chest Without IV Contrast For stage I patients who undergo nonfertility sparing treatment, the use of imaging for surveillance of cervical cancer in asymptomatic patients should be based on symptomatology and the degree of clinical concern such as clinical examination findings or pelvic, abdominal, or pulmonary symptoms [37]. For stage II to IV patients, CT of the chest may be used within 3 to 6 months after completion of therapy; however, NCCN guidelines indicate preference for PET/CT for this purpose [37]. Although the use of IV contrast material is preferred, the assessment may be performed without IV contrast. Imaging of the chest, abdomen, and pelvis is often concurrently performed. Follow-up of Invasive Cancer of the Cervix FDG-PET/CT Skull Base to Mid-Thigh FDG PET/CT is useful in the evaluation of local and distant recurrence even in asymptomatic patients, as well as in excluding metastatic disease in patients with pelvic recurrence amenable to radical surgery [5,37,54]. A meta- analysis including 18 studies and 762 patients showed that PET/CT had a pooled sensitivity and specificity of 92% (95% CI, 91%-94%) and 84% (95% CI, 74%-91%) and an area under the curve of 0.95 [70]. In another meta- analysis, the pooled sensitivity and specificity of PET/CT to detect local recurrence was 82% (95% CI, 72%-90%) and 98% (95% CI, 96%-99%), whereas that for distant metastasis was 87% (95% CI, 80%-92%) and 97% (95% CI, 96%-98%) [71]. In a retrospective study with 84 patients, higher MTV was associated with a higher rate of recurrence in patients with stage IIB to IVA cervical cancer [72]. Additional studies have indicated that metabolic parameters including SUVmax, MTV, and TLG may help predict outcomes including overall survival and therefore can influence the follow-up imaging strategy [43,46,73,74].