Diffusion-weighted MRI and 18F-FDG-PET/CT imaging: competition or synergy as diagnostic methods to manage sarcoma of the uterus? A systematic review of the literature. Issue 1 (January 2017)

• Record Type: Journal Article
• Authors: Dubreuil, Julien; Tordo, Jeremie; Rubello, Domenico; Giammarile, Francesco; Skanjeti, Andrea
• Is Part Of: Nuclear medicine communications. Volume 38:Issue 1(2017:Jan.)
• Publication Date: 2017-01
• Subjects: diffusion-weighted images -- fluorine-18-fluorodeoxyglucose -- management -- MRI -- PET -- systematic review -- uterine sarcoma; Nuclear medicine -- Periodicals; 616.07575
• DOI: 10.1097/MNM.0000000000000612
• Languages: English
• ISSNs: 0143-3636

Abstract

Abstract : Aim: To evaluate the diagnostic performance of fluorine-18-fluorodeoxyglucose PET/computed tomography ( 18 F-FDG-PET/CT) and MRI with diffusion-weighted images (DWI) in uterine sarcomas (US). Patients and methods: A systematic review was performed on Medline, ISI web of knowledge, and Scopus databases for studies reporting the diagnostic performance of 18 F-FDG-PET/CT and DWI-MRI in US published up to 15 February 2016. Exclusion criteria were articles with fewer than five cases of US, without DWI-MRI, and previous series of patients from the same researcher team. Results: Seven studies were selected for DWI-MRI and 11 for 18 F-FDG-PET/CT. DWI-MRI was used only to characterize uterine tumors, and showed a good sensitivity but a low specificity. The apparent diffusion coefficient value seems to be the most discriminant between benign and malignant lesion. No data were available on staging and restaging. 18 F-FDG-PET/CT improved patients' management when used for characterization, staging, and restaging because of its quite good accuracy. To date, few data exist on the prognostic role of 18 F-FDG-PET/CT. Well-designed multicenter prospective trials are needed to establish definitively the exact role of imaging in the management of US. Conclusion: Both DWI-MRI and 18 F-FDG-PET/CT have their own advantages, and should be performed in a 'one stop shop' scan in the near future by PET/MRI engines.