18-F-Fluorodeoxyglucose-Positron Emission Tomography Evaluation of Early Metabolic Response During Radiation Therapy for Cervical Cancer

Julie K. Schwarz, Lillie L. Lin, Barry A. Siegel, Tom R. Miller, Perry W. Grigsby

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46 Scopus citations


Purpose: To document changes in cervical tumor 18-F-fluorodeoxyglocose (FDG) uptake during radiation therapy and to correlate those changes with post-treatment tumor response and survival outcome. Methods and Materials: A total of 36 patients with Stage Ib1 to IIIb cervical cancer were enrolled in an institutional protocol examining the use of fluorodeoxyglucose-positron emission tomography (FDG-PET) for brachytherapy treatment planning. As part of this study, FDG-PET or PET/computed tomograpy (CT) images were obtained before, during, and after the completion of radiation therapy. Tumor metabolic responses were assessed qualitatively and semi-quantitatively by measurement of the maximal standardized uptake value (SUVmax). Results: Post-treatment FDG-PET images were obtained for 36 patients in this study. Of the patients, 29 patients had a complete metabolic response on the post-treatment PET, 4 had a partial metabolic response, and 3 had new sites of FDG uptake. Six patients had a complete metabolic response observed during radiation therapy, 26 had a partial metabolic response and 4 had stable or increased tumor metabolic activity. For patients with complete metabolic response during radiation therapy, median time to complete response was 29.5 days (range, 18-43 days). The mean cervical tumor SUVmax decreased from 11.2 (SD, 6.3; range, 2.1-38.0) pretreatment to 2.4 (SD, 2.7; range, 0-8.8) mid treatment, and 0.5 (SD, 1.7; range, 0-8.3) post-treatment. Conclusions: During radiation therapy for cervical cancer, FDG-PET can be used to monitor treatment response. Complete metabolic response during radiation therapy was observed for a subset of patients. Recommendations regarding the optimal timing of FDG-PET during treatment for cervical cancer will require further systematic study.

Original languageEnglish
Pages (from-to)1502-1507
Number of pages6
JournalInternational Journal of Radiation Oncology Biology Physics
Issue number5
StatePublished - Dec 1 2008


  • Brachytherapy
  • Cervix cancer
  • Radiation
  • Response


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