Usefulness of 18F-Fluorodeoxyglucose positron emission tomography in the follow up patients malignant mixed mullerian tumors of the uterine

The aim was to compare FDG-PET findings with serum CA 125 levels and anatomical imaging finding in detecting residual disease and/or recurrence of malignant mixed Mullerian tumors (MMMT) Ten patients, who underwent FDG-PET scans between 1997 and July 2004, were included. A focal accumulation of FDG, which could be distinguished from physiologic accumulation, was regarded as abnormal. We also reviewed serum CA 125 levels, anatomical images and histopathological results. Three of ten patients was shown abnormal FDG uptake during follow up. In two of 3, FDG-PET scan were performed after surgery and in the other one before surgery. In cases of abnormal FDG-PET finding. one patient had high serum CA 125 levels. who had high fractions of carcinomatous element on histopathological results. FDG-PET scans showed metastatic lesions in unsuspected location (supraclavicula lymph nodes, lung and gall bladder fossa), which could not detect by anatomical imaging. Another had normal serum CA 125 levels, who had high percentages of sarcomatous element on histopathological results and CT scan could only detect a few lesions. The other patient, who was performed FDG-PET scan before surgery had high serum CA 125 levels and also had high fractions of carcinomatous element. Seven patients, who had no evidence of recurrence on FDG-PET, normal serum CA 125 levels and showed no clinical recurrence. The mean disease free intervals of 7 patients were 36.43±5.97 months and mean follow up were 51.71±12.19 months. While, 2 patients with abnormal finding had mean follow up 6±4.24 months (p < 0.05) and never became disease-free condition (p < 0.01) FDG-PET scan could be a useful modality for follow up MMMT patients after treatment. Especially, the cases, which has high fractions of sarcomatous element, because serum CA 125 levels was not reliable and some lesions could be miss in anatomical imaging