Update of the role of PET/CT and PET/MRI in the management of patients with cervical cancer

Abstract

In cervical cancer (CC), fluorine18-fluorodeoxyglucose C'F-FDG) positron emission tomography/ computed tomography (PET/CT) has been proven to be benefkial for patient management. Positron emission tomography/CT is useful in pretreatment evaluation due to theabilitytoevaluate diseaseextent and to assess regional lymph nodes as well as distant sites for metastases PET/CT has an impact on treatment planning as well as it is incorporated in radiation therapy planning, resulting in more appropriateand effective treatment with lesscostand radiation doseto normal tissues. Positron emission tomography/CT is used to predict early treatment response and to assess treatment response after completion of concurrent chemoradiation therapy. PET/CT has been used for surveillance after treatment as well as for restaging in suspected recurrent or metastatic disease. Qualitative PET/CT imagi ng findingsas well as quantitative parameters such as maximum stan-da rdized uptake value (SUVmax),metabolictumor volume (MTV), and total lesion glycolysis (TLG) are useful to predict prognosis and clinical outcome. Moreover, PET imaging using other radiotracers to detect and quantify hypoxia may help to identify aggressive tumors and predict treatment outcome even though it is not widely clinical used. Positron emission tomography/magnetic resonance imaging (PET/MRI)ins-Trumentsarenowavailable, whichmay potentially improve evaluation of primary tumors and metastatic sites given the improved soft tissue contrast resolution of MRI relative to CT. This article reviews the role of "F-FDG PET/CT, hypoxia agent PET/CT, and "F-FDG PET/MRI in the management of patients with CC.