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False-Positive Rate of Posttherapy Positron Emission Tomography in Cervical Cancer
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To the Editor: In their study of tumor response and survival in cervical carcinoma, Dr Schwarz and colleagues1 found a 3-year cause-specific survival of 43% in patients with cervical cancer who had persistent positron emission tomography (PET) with F-18 fluorodeoxyglucose (FDG) uptake in the irradiated region following therapy. However, it is not clear what percentage of patients with persistent FDG activity had truly persistent neoplastic disease.
The authors note one study that has shown that residual FDG uptake in normal lung tissue may have positive correlation with non–small-cell lung cancer tumor responsiveness,2 yet there has been discussion in other cervical cancer studies that residual FDG-PET signal in the pelvis may not always represent persistent tumor activity.3-4 It would be helpful to know if the authors were able to determine by biopsy or by clinical course the false-positive rate of posttherapy FDG-PET as an early determination of local failure.
Financial Disclosures: . . . [Full Text of this Article]
Geoffrey R. Oxnard, MD
goxnard@partners.org
Department of Medicine
Massachusetts General Hospital
Boston
RELATED ARTICLE
Association of Posttherapy Positron Emission Tomography With Tumor Response and Survival in Cervical Carcinoma
Julie K. Schwarz, Barry A. Siegel, Farrokh Dehdashti, and Perry W. Grigsby
JAMA. 2007;298(19):2289-2295.
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RELATED LETTER
False-Positive Rate of Posttherapy Positron Emission Tomography in Cervical Cancer—Reply
Julie K. Schwarz, Barry A. Siegel, Farrokh Dehdashti, and Perry W. Grigsby
JAMA. 2008;299(8):898.
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