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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adult, Aged, Aged, 80 and over, False Positive Reactions, Female, Humans, Middle Aged, Neoplasm Metastasis, Neoplasm Staging, Positron-Emission Tomography, Predictive Value of Tests, Retrospective Studies, Uterine Cervical Neoplasms.
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Does positron emission tomography-computed tomography have a clinical impact for patients with cervical cancer? Context: Many studies have found that positron emission tomography-computed tomography (PET-CT) has a high sensitivity and specificity in the identification of metastasis in cervical cancer. Herlev Hospital, Denmark, has been performing PET-CTs in stage I-IV cervical cancer since 1 May 2006. The present study investigates the positive (PPV) and negative predictive value (NPV) of PET-CT in stage I disease and the clinical impact of the scan results in all disease stages. In this retrospective study, 83 consecutive patients with cervical cancer were included between 1 May 2006 and 1 November 2007. Data were collected from patient records and PET-CT reports. Among 47 stage I patients, four had PET-positive findings on the scan in addition to cervical cancer. Only one was a true positive finding. Pelvic lymphadenectomy was performed in 36 stage Ia2-Ib1 patients. Histology from stage I patients revealed a PPV of 25% and a NPV of 88%. Among a total of 36 stage II-IV patients, 14 had PET-positive findings. Five patients had a biopsy performed. Three of these patients were true positives and two were true negatives. Taking of biopsies in the remaining patients was clinically irrelevant. Five patients (6%), all in stage ≥ IIb, were offered an alternative treatment owing to the additional information obtained from the PET-CT.
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PET-CT is useful in the identification of metastatic disease in cervical cancer and it may assist optimal treatment planning; especially in International Federation of Gynecologists & Obstetricians (FIGO) stage > I cancers. Histological verification of PET-positive findings is necessary. The clinical value of PET-CT in early stage cervical cancer may be questioned. Final Decision: yes