Cervical cancer - staging and restaging with 18F-FDG PET/CT

Abstract

Cervical cancer is the third most frequent tumor and the fourth in mortality among Brazilian woman. In 2018, it is estimated there were over 16,000 new cases of the disease1. Its etiologic agent is the Human Papillomavirus (HPV), which is transmitted through sex and also causes other neoplasms, such as of the head and neck, penis, and oropharynx2. Positron emission tomography (PET) is an exam with ample indication for staging and restaging of solid tumors with precise and well-established indication for other gynecological tumors, such as breast cancer. When it is associated with a computed tomography (CT) study, it is called PET/CT. The tracer most commonly used in PET or PET/CT is the fludeoxyglucose marked with fluorine-18 (18F-FDG). International guidelines already recommend considering a 18F-FDG PET/CT in cases of cervical cancer from staging IB13. However, cervical cancer is still not established as an indication of PET/CT in our country in the Single Health System or the National Supplementary Health Agency. In this scenario, it is necessary to determine the role of 18F-FDG PET/CT in the staging and restaging of cervical cancer patients.