Comparative Study of Positron Emission Tomography/Computed Tomography and Computed Tomography in the Evaluation of Post-treatment Carcinoma Cervix Patients

Purpose of Study: To evaluate and compare imaging findings using computed tomography (CT) alone and positron emission tomography/CT (PET/CT) fusion imaging in posttreatment carcinoma cervix patients for recurrence. Subjects and Methods: From June 2014 to May 2016, 50 posttreatment carcinoma cervix patients were referred to our institution for PET/CT imaging. In all 50 of these patients referred for evaluation, a reliable reference standard was available. The reference standard was established by histopathological examination of accessible locoregional and nodal/distant metastatic involvement or follow-up of patients. CT and PET/CT were performed and analyzed for locoregional, pelvic nodal, and distant metastasis involvement in posttreatment carcinoma cervix cases. Results: In the evaluation of locoregional involvement, CT alone was found to have a sensitivity of 75% and specificity of 90% while PET/CT was found to have a sensitivity of 95% and specificity of 100%. Furthermore, in evaluation of pelvic nodal involvement, CT alone was found to have a sensitivity of 72% and specificity of 92.6% while PET/CT was found to have a sensitivity of 95.5% and specificity of 92.9%. In context to distant metastasis involvement (including para-aortic nodes), CT alone was found to have a sensitivity of 91.7% and specificity of 96.2% while PET/CT was found to have a sensitivity of 95.8% and specificity of 100%. PET/CT fusion in comparison to CT alone is better in sensitivity and specificity in the detection of locoregional involvement, pelvic node invasion, and distant metastasis in posttreatment carcinoma cervix cases.