Pre-op CT could detect distant metastatic disease in women with advanced cancers

PET and CT scans could be underrated diagnostic tools when it comes to gynecologic cancer, one Radiology study suggests. In research led by Michael S. Gee, MD, PhD, the imaging techniques were able to detect unsuspected distant metastases in dozens of women with cervical and endometrial cancers. CT scans are standard procedure when it comes to cancer screening, Gee and colleagues wrote in their study, but it isn’t a tell-all miracle worker.

“Standard CT imaging performed prior to surgery may not detect all distant sites of metastatic disease,” Gee said in a release from the Radiological Society of North America. “If distant metastatic disease is detected prior to surgery, there is an early opportunity to direct therapy at the sites of metastatic disease and potentially avoid complications associated with procedures such as lymph node dissection.”

Preemptive identification of metastasis could make a big difference for cancer patients—especially those with progressive cancers like advanced cervical or high-risk endometrial cancer, which, combined, account for 14,000 cancer deaths and 65,000 new diagnoses per year in the U.S, according to the National Cancer Institute.

Green and his team analyzed the effectiveness of preoperative fluorine fluorodeoxyglucose PET/CT scanning in a group of 153 cervical cancer and 203 endometrial cancer patients recruited from 28 medical centers across the country. The trial was sponsored by the American College of Radiology Imaging Network and Gynecology Oncology Group.

The combined PET/CT technique did detect distant, unsuspected metastases in a “substantial portion” of the study population, Gee and co-authors wrote. The overall prevalence of distant metastasis was 13.7 percent—21 patients—for cervical cancer and 11.8 percent—24 patients—for endometrial cancer, and the study detected the majority of metastases with high specificity and positive predictive value.

“A substantial portion of patients in our study group with cervical or endometrial cancer had distant metastatic disease that was not known prior to imaging,” Gee said. “PET/CT played a critical role in treatment planning for these patients.”

The authors said more research is needed to determine if these results are something that could influence treatment decisions and improve patient outcomes in the future.