The Application Value Of ¹⁸F-FDG PET-CT Imaging In The Diagnosis Of Primary Cervical Cancer And Follow-up Monitoring Of Cervical Cancer After Treatment

Objective To investigate the change relation of SUVmax value of ¹⁸F-FDG PET-CT imaging in primary cervical cancer,comparing the relationship between the pathological type,histological differentiation and FIGO staging of cervical cancer.To investigate the diagnostic value of ¹⁸F-FDG PET-CT imaging combined with serum squamous cell carcinoma antigen?SCC-Ag?to monitor the recurrence and metastasis of follow-up patients after treatment of cervical cancer.To analyze the correlation between the SUVmax of recurrent and metastatic lesions and the value of SCC-Ag.Materials and Methods Material 1.A total of 64 patients with cervical cancer who underwent the ¹⁸F-FDG PET-CT examination in PET-CT center were selected in this study,which from January 2012 to June 2016 in our hospital,all the patients were diagnosed as cervical cancer by pathology,and without any treatment before PET-CT examination.2.A total of 65 patients with cervical cancer after treatment who underwent the ¹⁸F-FDG PET-CT examination in PET-CT center were selected in this study,which from June 2011 to February 2016 in our hospital,the SCC-Ag of all the patients were elevated?above 1.5 ug/L?,all the recurrence and metastasis were confirmed by pathology and the follow-up of clinical and imaging.Method 1.A retrospective analysis were conducted in 64 untreated cervical cancer patients who underwent the ¹⁸F-FDG PET-CT examination.The SUVmax values of two groups?squamous cell carcinoma and adenocarcinoma,early stage and advanced stage?were compared by t-text,and the SUVmax values of three groups?welldifferentiated,middle differentiation and poorly differentiated squamous?were compared by analysis of variance.We chose q-text to compare each of the two groups when the three groups of data are not equal.2.A retrospective analysis were conducted in 65 cervical cancer patients after treatment with high SCC-Ag and underwent the ¹⁸F-FDG PET-CT examination.To analyze the diagnostic efficacy of PET-CT imaging in cervical cancer recurrence and metastasis,the results of PET-CT imaging and clinic/image follow-up were compared by Chi square test,and consistency analysis by Kappa test.To draw the scatter diagram of SUVmax and SCC-Ag,we analyze the correlation between the two groups of data by Pearson correlation analysis.Results 1.The range of SUVmax values in 64 primary cervical lesions were 2.9-26.8,and the average SUVmax was 12.05±5.43.The average SUVmax of squamous cell carcinoma was 13.01±5.07,and the average SUVmax of was 6.88±4.43.The squamous cell carcinoma was significantly higher than adenocarcinoma?t=3.573,P<0.05?.2.The range of SUVmax values in 54 primary squamous cell carcinoma were 2.9-26.8,and the average SUVmax of well-differentiated,moderately differentiated and poor differentiated groups were 8.68±3.44,12.32±4.43 and 16.54±5.21,respectively.The analysis of variance show that the SUVmax of three groups were not equal,and the q-test show that the differences were statistically significant between well-differentiated and poor differentiated groups,and moderately differentiated and poor differentiated groups.3.The average SUVmax of early cervical cancer group?FIGO staging ?B-?A?was 10.21±4.66,and the average SUVmax of advanced cervical cancer group?FIGO staging ?B-?B?was 14.14±5.55.There was significant difference in SUVmax between the two groups.4.The range of SCC-Ag in 65 follow-up patients after treatment of cervical cancer were 1.7-23.3ug/L,and the average SCC-Ag was 6.34±5.43ug/L.The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of ¹⁸F-FDG PET-CT imaging in the diagnosis of cervical cancer of recurrence and metastasis were 92.31%?60/65?,98.04%?50/51?,71.43%?10/14?,92.59%?50/54?and 90.91%?10/11?,respectively.There was no statistically significant difference between PET-CT imaging result and pathology/follow-up result.The two results were more consistent?Kappa=0.753,P<0.001?.5.To draw the scatter diagram of SUVmax and SCC-Ag in 50 true positive patients,Pearson correlation analysis show that there was no correlation between the two groups of data,and the correlation coefficient was 0.216.6.For the cervical cancer after treatment with high SCC-Ag,¹⁸F-FDG PET-CT imaging could early and fully detected the occult lesions that could not be detected by other imaging methods.Conclusion 1.The value of SUVmax in the primary lesions of cervical cancer was related to the pathological type,histological differentiation and FIGO stage.¹⁸F-FDG PET-CT imaging in patients with cervical cancer before treatment can be used to predict the degree of malignancy,guide the treatment and evaluate the prognosis of cervical cancer.2.The detection rate of recurrence and metastasis by using ¹⁸F-FDG PET-CT imaging for the follow-up cervical cancer patients after treatment with high SCC-Ag was higher,and the position was accurate,which could provide the objective basis for the clinical treatment plan.