The Role of Chest Computed Tomography in the Work-up of Patients with Cervical or Endometrial Cancer
Serap Demir, Johanna M. A. Pijnenborg, Ruud L. M. Bekkers
DOI: 10.4236/jct.2011.24059   PDF   HTML     4,859 Downloads   8,516 Views  


Background and Objectives: To determine whether chest CT-scan in patients with cervical or endometrial cancer is of additional value for planning initial treatment and work-up. Methods: A retrospective analysis was performed of 465 patients diagnosed with cervical or endometrial cancer between January 2003 and December 2007. All patients who underwent a chest CT-scan before treatment were included for analysis. Results: Out of 465 patients 74 patients underwent a pre-treatment chest CT-scan (cervical cancer, n = 58, and endometrial cancer, n = 26). Abnormalities were detected in 53.4% (31/58) and 73.1% (19/26) of patients with cervical and endometrial cancer, respectively. The majority of abnormalities were presumed to be benign, yet work-up was adjusted in 28.6% (13/58 and 11/26), and therapy was adjusted in 17.6% (6/58, and 7/26) of patients with cervical and endometrial cancer. Pulmonary metastasis were observed in 10.3% (6/58) and 24.1% (7/26) of patients with cervical cancer, and endometrial cancer, respectively. Most patients with pulmonary metastasis presented with extended disease based on clinical examination. Conclusions: Chest CT scans in patients with cervical and endometrial cancer frequently demonstrate abnormalities that are most likely benign, yet work-up is adjusted in a substantial number of cases. Therefore, chest CT-scan is only recommended for those patients with a clinical suspicion of extended disease.

Share and Cite:

S. Demir, J. Pijnenborg and R. Bekkers, "The Role of Chest Computed Tomography in the Work-up of Patients with Cervical or Endometrial Cancer," Journal of Cancer Therapy, Vol. 2 No. 4, 2011, pp. 441-447. doi: 10.4236/jct.2011.24059.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] American Cancer Society, “Cancer Facts and Figures 2008,” Atlanta, 2008.
[2] S. Pecorelli, “Revised FIGO Staging for Carcinoma of the Vulva, Cervix, and Endometrium,” International Journal of Gynecology and Obstetrics, Vol. 105, No. 2, 2009, pp. 103-104. doi:10.1016/j.ijgo.2009.02.012
[3] S. E. Waggoner, “Cervical Cancer,” Lancet, Vol. 361, No. 9376, 2003, pp. 2217-2225. doi:10.1016/S0140-6736(03)13778-6
[4] T. Koyama, K. Tamai and K. Togashi, “Staging of Carcinoma of the Uterine Cervix and Endometrium,” European Radiology, Vol. 17, No. 8, 2007, pp. 2009-2019. doi:10.1007/s00330-006-0555-0
[5] J. Scheidler and A. F. Heuck, “Imaging of Cancer of the Cervix,” Radiologic Clinics of North America, Vol. 40, No. 3, 2002, pp. 577-590. doi:10.1016/S0033-8389(01)00007-0
[6] S. Pecorelli, J. L. Benedet, W. T. Creasman and J. H. Shepherd, “FIGO Staging of Gynecologic Cancer,” International Journal of Gynecology and Obstetrics, Vol. 64, 1999, pp. 5-10.
[7] S. C. Ballon, M. L. Berman, R. C. Donaldson, W. A. Growdon and L. D. Lagasse, “Pulmonary Metastases of Endometrial Carcinoma,” Gynecologic Oncology, Vol. 7, No. 1, 1979, pp. 56-65. doi:10.1016/0090-8258(79)90081-7
[8] S. Sone, S. Takashima, F. Li, Z. Yang, T. Honda, Y. Maruyama, et al., “Mass Screening for Lung Cancer with Mobile Spiral Computed Tomography Scanner,” Lancet, Vol. 351, No. 9111, 1998, pp. 1242-1245. doi:10.1016/S0140-6736(97)08229-9
[9] C. I. Henschke, D. I. McCauley, D. F. Yankelevitz, D. P. Naidich, et al., “Early Lung Cancer Action Project: Overall Design and Findings from Baseline Screening,” Lancet, Vol. 354, No. 9173, 1999, pp. 99-105. doi:10.1016/S0140-6736(99)06093-6
[10] A. E. Chang, E. G. Schaner, D. M. Conkle, et al., “Evaluation of Computed Tomography in the Detection of Pulmonary Metastases. A Prospective Study,” Cancer, Vol. 43, No. 3, 1979, pp. 913-916.
[11] O. Akin, S. Mironov, N. Pandit-Taskar and L. E. Hann, “Imaging of Uterine Cancer,” Radiologic Clinics of North America, Vol. 45, No. 1, 2007, pp. 167-182. doi:10.1016/j.rcl.2006.10.009
[12] M. Follen, C. F. Levenback, R. B. Iyer, P. W. Grigsby, et al., “Imaging in Cervical Cancer,” Cancer, Vol. 98, No. S9, 2003, pp. 2028-2038. doi:10.1002/cncr.11679
[13] R. Iyer, “Imaging of Gynecologic Malignancy,” Seminars in Roentgenology, Vol. 39, No. 3, 2004, pp. 428-436. doi:10.1016/
[14] J. R. Muhm, L. R. Brown and J. K. Crowe, “Detection of Pulmonary Nodules by Computed Tomography,” American Journal of Roentgenology, Vol. 128, 1977, pp. 267-270.
[15] M. Kaneko, K. Eguchi, H. Ohmatsu, et al., “Peripheral Lung Cancer: Screening and Detection with Low-Dose Spinal CT versus Radiography,” Radiology, Vol. 2001, 1996, pp. 798-802.
[16] W. R. Webb, “Radiologic Evaluation of the Solitary Pulmonary Nodules,” American Journal of Roentgenology, Vol. 154, 1990, pp. 701-708.
[17] E. A. Zerhouni, F. P. Stitik, S. S. Siegelman, et al., “CT of the Pulmonary Nodule: A Cooperative Study,” Radiology, Vol. 160, 1986, pp. 319-327.
[18] A. G. Shumsky, P. M. A. Brasher, G. C. E. Stuart and J. G. Nation, “Risk-Specific Follow-Up for Endometrial Carcinoma Patients,” Gynaecologic Oncology, Vol. 65, 1997, pp. 379-382.
[19] M. Imachi, N. Tsukamoto, T. Matsuyama and H. Nakano, “Pulmonary Metastasis from Carcinoma of the Uterine Cervix,” Gynecologic Oncology, Vol. 33, No. 2, 1989, pp. 189-192. doi:10.1016/0090-8258(89)90549-0
[20] A. W. K. Tang, H. A. Moss and R. J. H. Robertson, “The Solitary Pulmonary Nodule”, European Journal of Radiology, Vol. 45, No. 1, 2003, pp. 69-77. doi:10.1016/S0720-048X(02)00297-8
[21] S. S. Siegelman, F. P. Stitik and W. R. Summer, “Management of the Patient with a Localized Pulmonary Lesion in Pulmonary System,” In: S. S. Siegelman, F. P. Stitik, W. R. Summer and P. O. Alderson, Eds., Practical Approaches to Pulmonary Diagnosis, Grune & Straton, New York, 1979, pp. 339-358.
[22] S. S. Siegelman, N. F. Khouri, F. P. Leo, et al., “Solitary Pulmonary Nodules: CT Assessment,” Radiology, Vol. 160, 1986, pp. 307-312.
[23] J. L. Leef III and J. S. Klein, “The Solitary Pulmonary Nodule,” Radiologic Clinics of North America, Vol. 40, No. 1, 2002, pp. 123-143. doi:10.1016/S0033-8389(03)00113-1
[24] D. P. Naidich, E. A. Zerhouni, S. S. Siegelman and R. Moncada, “Computed Tomography of the Thorax,” Raven Press, New York, 1984, pp. 171-199.
[25] E. Dinkel, A. Mundinger, D. Schopp, G. Grosser and K. H. Hauenstein, “Diagnostic Imaging in Metastatic Lung Disease,” Lung, Vol. 168, 1990, pp. 1129-1136.
[26] S. D. Davis, “CT Evaluation for Pulmonary Metastases in Patients with Extrathoracic Malignancy,” Radiology, Vol. 180, 1991, pp. 1-12.
[27] Y. Sugawara, A. Eisbruch, S. Kosuma, B. E. Recker, et al., “Evaluation of FDG PET in Patients with Cervical Cancer,” The Journal of Nuclear Medicine, Vol. 40, 1999, pp. 1125-1131.
[28] K. Kitajima, K. Murakami, E. Yamasaki, Y. Kaji and K. Sugimura, “Accuracy of Integrated FDG-PET/Contrast-Enhanced CT in Detecting Pelvic and Paraaortic Lymph Node Metastasis in Patients with Uterine Cancer,” European Radiology, Vol. 19, No. 6, 2009, pp. 1529-1536. doi:10.1007/s00330-008-1271-8
[29] D. H. Park, K. H. Kim, S. Y. Park, B. H. Lee, C. W. Choi and S. Y. Chin, “Diagnosis of Recurrent Uterine Cervical Cancer: Computed Tomography versus Positron Emission Tomography,” Korean Journal of Radiology, Vol. 1, No. 1, 2000, pp. 51-55. doi:10.3348/kjr.2000.1.1.51
[30] E. F. Patz, V. J. Lowe, J. M. Hoffman, et al., “Focal Pulmonary Abnormalities: Evaluation with F-18 Fluorodeoxyglucose PET Scanning,” Radiology, Vol. 188, 1993, pp. 487-490.
[31] W. De Wever, L. Meylaerts, L. De Ceuninck, S. Stroobants and J. A. Verschakelen, “Additional Value of Integrated PET-CT in the Detection and Characterization of Lung Metastases: Correlation with CT Alone and PET Along,” European Radiology, Vol. 17, No. 2, 2007, pp. 467-473. doi:10.1007/s00330-006-0362-7
[32] C. H. Lai, K. G. Huan, L. C. See, T. C. Yen, et al., “Restaging of Recurrent Cervical Carcinoma with Physe [18F]Fluoro-2-Deoxy-D-Glucose Positron Emission Tomography,” American Cancer Society, Vol. 100, 2004, pp. 544-552.
[33] T. C. Yen, L. C. See, T. C. Chang, et al., “Defining the Priority of Using 18F-FDG PET for Recurrent Cervical Cancer,” Journal of Nuclear Medicine, Vol. 45, 2004, pp. 1632-1639.
[34] T. Saga, T. Higashi, T. Ishimori, M. Mamede, et al., “Clinical Value of FDG-PET in the Follow-Up of Post-Operative Patients with Endometrial Cancer, “Annals of Nuclear Medicine, Vol. 17, No. 3, 2003, pp. 197-203. doi:10.1007/BF02990022
[35] T. Belhocine, C. De Barsy, R. Hustinx and J. Willems-Foidart, “Usefulness of 18F-FDG PET in the Post-Therapy Surveillance of Endometrial Carcinoma,” European Journal of Nuclear Medecine and Molecular Imaging, Vol. 29, No. 9, 2002, pp. 1132-1139. doi:10.1007/s00259-002-0878-2
[36] A. Husain, T. Akhurst, S. Larson, K. Alektiar, R. R. Barakat and D. S. Chi, “A Prospective Study of the Accuracy of 18Fluorodeoxyglucose Positron Emission Tomography (18FDG PET) in Identifying Sites of Metastasis Prior to Pelvic Exenteration,” Gynecologic Oncology, Vol. 106, No. 1, 2007, pp. 177-180. doi:10.1016/j.ygyno.2007.03.018
[37] R. Jover, D. Lourido, C. Gonzalez, A. Rojo, L. Gorospe and J. M. Alfonso, “Role of PET/CT in the Evaluation of Cervical Cancer,” Gynecologic Oncology, Vol. 110, No. 3, 2008, pp. S55-S59. doi:10.1016/j.ygyno.2008.05.023

Copyright © 2022 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.