In a meta-analysis that included 4 studies that evaluated use of CT for this purpose, the summary estimate of the sensitivity of CT was 90% (95% CI, 82%-94%), and the specificity was 76% (95% CI, 44%-93%) [82]. Dual-phase study without and with IV contrast is unnecessary. CT Chest Without IV Contrast CT may be used for the assessment of known distant recurrence, preferably with the use of IV contrast [37]. In a meta-analysis that included 4 studies that evaluated use of CT for this purpose, the summary estimate of the sensitivity of CT was 90% (95% CI, 82%-94%), and the specificity was 76% (95% CI, 44%-93%) [82]. Imaging of the chest, abdomen, and pelvis is often concurrently performed for evaluation of distant metastatic disease. FDG-PET/CT Skull Base to Mid-Thigh NCCN guidelines support the use of PET/CT over CT for the evaluation of metastatic disease [37]. In patients with suspected recurrence, FDG-PET/CT is useful in detection of local and distant disease, as well as in excluding metastatic disease in patients with pelvic recurrence who are amenable to radical surgery [37,54]. A meta-analysis of 9 PET/CT studies in mostly symptomatic women found an overall sensitivity of 95% (95% CI, 91%-97%) and a specificity of 87% (95% CI, 82%-91%) for detection of recurrent disease [82]. PET/CT is also helpful in assessment of metabolic response and has been shown to correlate well with radiologic response [47]. FDG-PET/MRI Skull Base to Mid-Thigh There is limited literature on use of PET/MRI for the evaluation of known or suspected recurrent disease; however, a retrospective study on 31 patients found PET/MRI to be useful in the assessment of recurrent and metastatic disease and also found that there was a significant inverse correlation between SUVmax and ADC values [75].
Pretreatment Evaluation and Follow up of Invasive Cancer of the Cervix. In a meta-analysis that included 4 studies that evaluated use of CT for this purpose, the summary estimate of the sensitivity of CT was 90% (95% CI, 82%-94%), and the specificity was 76% (95% CI, 44%-93%) [82]. Dual-phase study without and with IV contrast is unnecessary. CT Chest Without IV Contrast CT may be used for the assessment of known distant recurrence, preferably with the use of IV contrast [37]. In a meta-analysis that included 4 studies that evaluated use of CT for this purpose, the summary estimate of the sensitivity of CT was 90% (95% CI, 82%-94%), and the specificity was 76% (95% CI, 44%-93%) [82]. Imaging of the chest, abdomen, and pelvis is often concurrently performed for evaluation of distant metastatic disease. FDG-PET/CT Skull Base to Mid-Thigh NCCN guidelines support the use of PET/CT over CT for the evaluation of metastatic disease [37]. In patients with suspected recurrence, FDG-PET/CT is useful in detection of local and distant disease, as well as in excluding metastatic disease in patients with pelvic recurrence who are amenable to radical surgery [37,54]. A meta-analysis of 9 PET/CT studies in mostly symptomatic women found an overall sensitivity of 95% (95% CI, 91%-97%) and a specificity of 87% (95% CI, 82%-91%) for detection of recurrent disease [82]. PET/CT is also helpful in assessment of metabolic response and has been shown to correlate well with radiologic response [47]. FDG-PET/MRI Skull Base to Mid-Thigh There is limited literature on use of PET/MRI for the evaluation of known or suspected recurrent disease; however, a retrospective study on 31 patients found PET/MRI to be useful in the assessment of recurrent and metastatic disease and also found that there was a significant inverse correlation between SUVmax and ADC values [75].