tailieunhanh - Gynecological Tumors

Gynecological cancers as a group comprise approximately 11% of female cancer. 1 In the United States, it is estimated that nearly 80,720 women will be diagnosed in 2009 with gynecological cancers and that approximately 28,120 women will die as a result of these cancers (accounting for 10%of all cancer-related deaths in women). Gynecological cancers are typically diagnosed by history, physical examination, and selected imaging studies. There has been an increasing use of PET using 18 F-fluorodeoxyglucose (FDG) for staging and restaging of these cancers, as well as for assessing response to therapy. . | Chapter Gynecological Tumors Farrokh Dehdashti and Barry A. Siegel Introduction Gynecological cancers as a group comprise approximately 11 of female In the United States it is estimated that nearly 80 720 women will be diagnosed in 2009 with gynecological cancers and that approximately 28 120 women will die as a result of these cancers accounting for 10 of all cancer-related deaths in women . Gynecological cancers are typically diagnosed by history physical examination and selected imaging studies. There has been an increasing use of PET using 18F-fluorodeoxyglucose FDG for staging and restaging of these cancers as well as for assessing response to Cervical Cancer In the United States cervical cancer is the third most common gynecological cancer with an estimated 11 270 new cases and 4 070 deaths expected in Squamous cell carcinomas represent over 90 of cervical cancers. Adenocarcinomas and adenosquamous carcinomas account for most of the remaining cases. 18F-FDG PET CT in Staging Cervical Cancer Cervical cancers initially spread locally and then through lymphatic channels before metastasizing to distant organs. Like other gynecological neoplasms cervical cancer is staged in accordance with the International Federation of Gynecology and Obstetrics FIGO system. Lymph node status is not included in this staging system despite the fact that the status of pelvic and para-aortic lymph nodes is an important determinant of prognosis in patients with locally advanced disease and guides treatment planning in patients undergoing radiation therapy. Since carcinoma of the uterine cervix initially grows locally the clinical staging of this cancer has relied on careful physical examination including examination under anesthesia and traditionally only selective radiological examinations have been used. More recently 18F-FDG PET has been recognized to improve evaluation of this cancer. F. Dehdashti Professor of Radiology Mallinckrodt Institute of .