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Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

2011, Número 3

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Rev Invest Clin 2011; 63 (3)


F18-FDG-PET/CT in the evaluation of patients with suspected recurrent or persistent locally advanced cervical carcinoma

Cetina L, Serrano A, Cantú-de-León D, Pérez-Montiel D, Estrada E, Coronel J, Hernández-Lucio M, Dueñas-González A

Idioma: Ingles.
Referencias bibliográficas: 39
Paginas: 227-235
Archivo PDF: 100.27 Kb.


RESUMEN

Antecedentes. El cáncer cervical (CC) representa la segunda neoplasia más frecuente y la tercera causa de muerte por cáncer entre las mujeres. La enfermedad recurrente o persistente se encuentra en relación con la etapa clínica, pero puede ser alta hasta en 70%. La tomografía computada con emisión de positrones (PET/CT) es un estudio de imagen que puede detectar la absorción incrementada de glucosa en los tejidos neoplásicos. Material y métodos. Se realizó PET/CT en pacientes con CC confirmado, que habían sido previamente tratadas y que desarrollaron síntomas sugestivos de recurrencia o enfermedad persistente con o sin evidencia de la enfermedad en una tomografía computarizada. Se evaluaron la sensibilidad, especificidad, valores predictivos de PET/CT y tomografía computarizada. Resultados. Dieciséis pacientes con una edad promedio de 47.2 años se incluyeron en el estudio entre abril 2007 y junio 2008. Trece pacientes (81.2%) presentaron síntomas. PET/CT fue positivo en 14/16 (85.7%). De éstos, 12 catalogados como Verdaderos Positivos (TP) y dos, Falsos Positivos (FP); otros dos casos fueron catalogados como Verdaderos Negativos (TN) (12.5%). Los sitios anatómicos más frecuentes de captación detectados por el PET/CT fueron el cuello uterino, los ganglios linfáticos retroperitoneales, iliacos, obturadores y mediastinales. El número de sitios anatómicos promedio con alta captación de Fluoro-desoxi-D-glucosa (FDG) fueron dos (rango, 1-7 sitios). PET/CT y TC presentaron sensibilidad de 100 y 91.7%, respectivamente. Especificidad para ambos 50%; valor predictivo positivo (PPV) 85.4 y 84.6%, respectivamente. Valor predictivo negativo (NPV) 100 y 66%, respectivamente. Precisión 88 vs. 81%, respectivamente. Conclusiones. El PET/CT tiene la capacidad para detectar el cáncer de cérvix recurrente o persistente; detecta el aumento de la actividad metabólica, principalmente, en el sitio primario o los ganglios linfáticos. Es necesario realizar estudios adicionales sobre PET/CT y esta entidad para confirmar el impacto real de este estudio sobre la detección temprana de la recurrencia de CC.


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