Fused functional-anatomic images of metastatic cancer of cervix obtained by a combined gamma camera and an X-ray tube hybrid system with an illustrative case and review of the ¹⁸F-fluorodeoxyglucose literature

Background. ¹⁸F-Fluorodeoxyglucose (FDG) assessments have provided clinically important information in cervical cancer. FDG studies can now be performed by both dedicated PET systems and by new-generation gamma cameras. Hybrid systems which consist of positron emission tomography (PET) or a gamma camera with X-ray for fusion of functional-anatomic data without changing the patient's position are now available. Case. A woman with newly diagnosed cervical cancer underwent preoperative FDG studies using a hybrid gamma camera. In addition to the known primary tumor, FDG detected heretofore unidentified metastatic disease at the liver, bone, and para-aortic lymph nodes: the treatment approach was consequently altered to chemo- and radiotherapy. The fused images provided precise localization of the lesions, guiding bone biopsy and radiation field planning. Conclusion. When PET is unavailable, a modified gamma camera can provide clinically relevant data in patients with cervical cancer.