All women, during their lifetime, are at risk of developing some form of gynecologic malignancy. The role of FDG-PET/CT has become more established in the management of gynecologic malignancies in the last decade

Gynecologic malignancy encompasses endometrial, ovarian, cervical, vaginal, and vulvar carcinoma from most to least prevalent. Every woman, regardless of her genetic predisposition, is at risk of developing some form of gynecologic malignancy during her lifetime.

Role of FDG-PET/CT

The role of FDG-PET/CT has become more established in the management of gynecologic malignancies in the last decade. In this article, we will review the role of FDG-PET/CT in endometrial, cervical, ovarian, and vaginal cancer, by highlighting its strengths and limitations.

While the role in initial or pre-operative staging for FDG-PET/CT is controversial, it allows noninvasive detection of equivocal or distant metastases, may alter stage and prognosis and can guide or help eliminate unnecessary interventions that may not be beneficial. FDG-PET/CT is a useful adjunct to traditional staging with MR and CT.

Vaginal cancer is the rarest form of gynecologic cancers comprising approximately 1% of all gynecologic cancers. Lamoreaux et al. concluded that FDG-PET alone demonstrates primary tumor and distant metastasis in vaginal cancer better than CT alone; however, there are very few studies comparing FDG-PET/CT to other imaging modalities.

Gynecologic malignancies account for a significant proportion of malignancies afflicting women in the United States. While the role in initial or pre-operative staging for FDG-PET/CT is controversial for all types of gynecologic malignancies, it remains a noninvasive way to detect equivocal or distant metastatic lymph nodes, and therefore affects prognosis.

In some cases, it may reduce overall management cost by avoiding interventions that may not be beneficial and consequently may improve quality of life for these patients. The role of FDG-PET/ CT has expanded significantly and may potentially become even more important in the management of gynecologic malignancies in the future