A multicenter study of 153 cervical cancer patients showed PET/CT had an overall sensitivity, specificity, PPV, and NPV of 54.8%, 97.7%, 79.3%, and 93.1%, respectively, for the detection of distant cervical cancer metastases. The most common sites of distant metastatic disease are the lung, peritoneum, supraclavicular lymph nodes, liver, and bone [33-35]. With regards to lymph node assessment, a meta-analysis of 72 studies showed PET to have superior performance to MRI and CT, with a pooled sensitivity of 75% and a specificity of 98%, compared to 56% and 93% for MRI and 58% and 92% for CT [36]. Another meta-analysis of 115 studies published from 2000 to 2019 also showed PET had superior performance, with a pooled sensitivity and specificity of 57% (95% CI, 48%-65%) and 95% (95% CI, 93%-97%) compared to 57% (95% CI, 49%-64%) and 93% (95% CI,89%-95%) for MRI and 51% (95% CI, 36%- 67%) and 87% (95% CI, 81%-92%) for CT [12]. The high specificity of PET/CT for nodal assessment allows for a high NPV of 93.1% [38]. This prospective study in 153 patients also showed that the addition of PET to diagnostic CT was associated with a mild but statistically significant increase in sensitivity to detect abdominal nodal metastases in advanced cervical cancer [38]. Follow-up of Invasive Cancer of the Cervix FDG-PET/MRI Skull Base to Mid-Thigh Although still not in widespread clinical use, research has shown PET/MRI to be a promising new modality for comprehensive examination of cervical cancer disease extent. The MRI examination offers ideal imaging of the primary tumor for local extent evaluation, whereas the PET component offers superior sensitivity for the detection of nodal and hematogenous metastases.
Pretreatment Evaluation and Follow up of Invasive Cancer of the Cervix. A multicenter study of 153 cervical cancer patients showed PET/CT had an overall sensitivity, specificity, PPV, and NPV of 54.8%, 97.7%, 79.3%, and 93.1%, respectively, for the detection of distant cervical cancer metastases. The most common sites of distant metastatic disease are the lung, peritoneum, supraclavicular lymph nodes, liver, and bone [33-35]. With regards to lymph node assessment, a meta-analysis of 72 studies showed PET to have superior performance to MRI and CT, with a pooled sensitivity of 75% and a specificity of 98%, compared to 56% and 93% for MRI and 58% and 92% for CT [36]. Another meta-analysis of 115 studies published from 2000 to 2019 also showed PET had superior performance, with a pooled sensitivity and specificity of 57% (95% CI, 48%-65%) and 95% (95% CI, 93%-97%) compared to 57% (95% CI, 49%-64%) and 93% (95% CI,89%-95%) for MRI and 51% (95% CI, 36%- 67%) and 87% (95% CI, 81%-92%) for CT [12]. The high specificity of PET/CT for nodal assessment allows for a high NPV of 93.1% [38]. This prospective study in 153 patients also showed that the addition of PET to diagnostic CT was associated with a mild but statistically significant increase in sensitivity to detect abdominal nodal metastases in advanced cervical cancer [38]. Follow-up of Invasive Cancer of the Cervix FDG-PET/MRI Skull Base to Mid-Thigh Although still not in widespread clinical use, research has shown PET/MRI to be a promising new modality for comprehensive examination of cervical cancer disease extent. The MRI examination offers ideal imaging of the primary tumor for local extent evaluation, whereas the PET component offers superior sensitivity for the detection of nodal and hematogenous metastases.