Purpose: The present study was conducted to clarify the role of carbon-11 choline ((11)C-choline) positron emission tomography (PET)/computed tomography (CT) in the management of uterine carcinoma.
Materials and methods: Twenty-two patients who underwent (11)C-choline PET/CT and pelvic MRI were evaluated retrospectively. The images were reviewed by a board-certified radiologist and a nuclear medicine specialist who were unaware of any clinical information, and a consensus was reached. Diagnostic accuracy of PET/CT was evaluated for staging. The reference standard consisted of histological examination (n = 17) and follow-up conventional CT (n = 5). In five patients with cervical carcinoma, (11)C-choline PET/CT was performed before and after treatment that consisted of cisplatin infusion and subsequent radiotherapy. Standardized uptake value (SUV) was compared with uni-dimensional and volumetric measurements that were made on magnetic resonance images (MRI) before and after treatment.
Results: Based on PET/CT interpretations, the reviewers correctly classified T stage in 8 patients (47%), N stage in 21 patients (96%), M stage in 20 patients (91%), and TNM stage in 15 patients (88%). Tumor size, volume, and SUV decreased after treatment in five patients with cervical carcinoma. Using the Pearson correlation test, a significant correlation was found between the reduction rate of SUV and reduction rate of tumor volume.
Conclusions: (11)C-choline PET/CT is an accurate means for the management of patients with uterine carcinoma. The combination of (11)C-choline PET/CT and MRI increases the accuracy of staging in patients with uterine carcinoma.