Present and future of PET and PET/CT in gynaecologic malignancies

ObjectivesTo review the published data in literature on patients affected by gynaecological malignancies to establish the role of 18F-FDG positron emission tomography (PET) and PET/CT in comparison to conventional imaging (CI).Materials and methodsAll papers specifically addressed to the role of 18F-FDG PET and PET/CT in gynaecological malignancies published on PubMed/Medline, in abstracts from the principal international congresses, in the guidelines from national Societies that had appeared in literature until November 2009 were considered for the purpose of the present study.Results and conclusionsThe use of 18F-FDG PET, and even more of 18F-FDG PET/CT, is increasing in the follow up of patients with gynaecologic malignancies and suspected recurrent disease: there is evidence in the literature that 18F-FDG PET/CT has a higher sensitivity than CI in depicting occult metastatic spread. An interesting issue is represented by patients with ovarian cancer with an increase of the specific biomarker, CA-125, and negative/inconclusive findings at CI. The use of 18F-FDG PET in differential diagnosis and staging is more controversial, but there is some evidence that a baseline PET examination performed before commencing therapy, for staging purpose, is also useful to evaluate the response to chemoradiation treatment. In several papers it has been suggested a relevant role of 18F-FDG PET/CT in evaluating the entity of response to treatment and therefore to plan the subsequent therapeutic strategy.