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The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2019 May 08

DOI: 10.23736/S1824-4785.19.03156-X

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

18F-FDG-PET/CT imaging of uterine cervical cancer recurrence in women with and without HIV infection

Ismaheel O. LAWAL 1, Kehinde O. OLOLADE 1, 2, Gbenga O. POPOOLA 3, Alfred O. ANKRAH 1, 4, Mariza VORSTER 1, Alex MAES 1, 5, 6, Neo P. MOKGORO 1, Christophe van de WIELE 1, 5, 7, Mike M. SATHEKGE 1

1 Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Pretoria, South Africa; 2 Department of Radiation Biology & Radiotherapy, University of Lagos, Lagos, Nigeria; 3 Department of Epidemiology and Community Health, University of Ilorin, Ilorin, Nigeria; 4 Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen & University of Groningen, Groningen, The Netherlands; 5 Department of Nuclear Medicine, AZ Groeninge, Kortrijk, Belgium; 6 Faculty of Medicine, Catholic University Leuven, Leuven, Belgium; 7 Department of Radiology and Nuclear Medicine, Ghent University, Ghent, Belgium


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BACKGROUND: To compare the rate, time and, pattern of recurrence of cervical cancer between patients with and without HIV infection and to determine factors predicting cervical cancer recurrence in patients evaluated by 18F-FDG-PET/CT.
METHODS: We reviewed the 18F-FDG-PET/CT images of patients with histologically proven cervical carcinoma who were presenting with suspected recurrence. We extracted epidemiologic data, previous treatment, histologic subtype, HIV status, viral load and CD4 counts from the electronic laboratory database and the referral form for the 18F-FDG-PET/CT study.
RESULTS: We studied 303 women including 112 HIV-infected patients. FIGO stage III disease was present in 131 patients. Of 198 patients with recurrence, 74 were HIV-infected while 124 were not (p=0.849). HIV infected patients were younger (41.99 ± 9.30 years) compared to HIV-uninfected (50.19 ± 11.09), p<0.001. Local recurrence was present in 125 patients while 100 patients had a distant recurrence. Recurrence occurred at a single site in 88 patients and two or more sites in 110 patients. No significant difference in the recurrent patterns between HIV-infected and uninfected patients. Median time to recurrence was 10.50 months (Range: 6.00-156.00) among HIV-infected versus 12.00 months (IQR:7.00-312.00) among the uninfected, p=0.065. FIGO stage III (p=0.042) and the presence of histological sub-types other than SCC (p=0.005) were significant predictors of recurrence. HIV infection by itself was not significant in predicting recurrence (p=0.843).
CONCLUSIONS: HIV infection has no significant impact on the rate, time or pattern of recurrence in women with suspected cervical carcinoma recurrence. Advanced disease and histological variant other than SCC are predictive of recurrence.


KEY WORDS: 18F-FDG-PET/CT - Carcinoma of the cervix - Squamous cell carcinoma - Recurrence - HIV infection

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