Background: Recurrent disease in post-irradiation patients with cervical cancer is often difficult to delineate on magnetic resonance imaging (MRI), because posttreatment changes can have a similar appearance, and further evaluation is often required. The aims of the study were to evaluate positron emission tomography/computed tomography with 18F-fluorodeoxyglucose (FDG PET-CT) diagnostic role in suspected recurrent cervical cancer after radiotherapy, compare it to MRI, and assess their prognostic impact in these patients. Patients and methods: This cohort retrospective study included patients previously treated with radiotherapy for carcinoma of uterine cervix with suspected recurrence, who had undergone MRI of abdomen and pelvis, and were subsequently evaluated on FDG PET-CT, with minimum follow-up period of 12 months. Results: In the total of 84 patients included in analysis, MRI vs . FDG PET-CT showed sensitivity, specificity and accuracy of 80.1%, 52.4% and 66.7%, vs . 97.6%, 61.9% and 79.8%, respectively. Patients with positive findings on MRI (Log Rank, p = 0.003) and PET-CT (Log Rank, p < 0.001) had shorter progression-free survival (PFS) than those with negative results. In univariate Cox regression models, MRI and FDG PET-CT results were found to be related to PFS (p = 0.005 and p < 0.001, respectively). However, multivariate analysis proved only FDG PET-CT to be independent prognostic factor, where patients with positive FDG PET-CT results had almost nine times higher risk of progression (p < 0.001). Conclusion: FDG PET-CT represents useful diagnostic tool in suspected recurrent cervical cancer after radiotherapy, showing high sensitivity in its detection. In addition, it is an independent factor in predicting progression-free survival in these patients.

Introduction: The aim of this investigation was to estimate the diagnostic performance of positron emission tomography/computed tomography using fluorine-18 fluoro-deoxyglucose (18F-FDG PET/CT) in the follow-up of post-treatment laryngeal squamous cell carcinoma (SCC) and the survival rate. Material and methods: Fifty seven patients (50 males, 7 females), mean age (68.3±6.7), with post-treatment laryngeal SCC were investigated. Indications for 18F-FDG PET/CT were: post-surgery staging, post-therapy restaging with positive/uncertain CT, follow-up, suspected recurrence on CT. 18F-FDG PET/CT findings were compared to the clinical follow-up of up to 10 years after imaging. The degree of metabolic activity was analyzed visually and semi-quantitatively using the maximum standardized uptake value (SUVmax). Results: A high accumulation of radiopharmaceutical was found in 41 (71.9%) patients who were considered true positive, physiological in 14 patients (24.5%) and only two males (3.5%) were false positive. Overall sensitivity of 18F-FDG PET/CT was 95.3%, specificity 100.0%, positive predictive value 100.0%, negative predictive value 87.5% and accuracy 96.5%. In 19 cases (33.3%) PET/CT findings significantly influenced further management of the patients. Progression-free survival (PFS) in the 18F-FDG positive group was 41.1±12.7 months. Statistically significant correlation between SUVmax and PFS was not observed (p>0.05). Conclusion: 18F-FDG PET/CT is a valuable tool for the follow-up of laryngeal SCC due to its high sensitivity, specificity, PPV, NPV and accuracy. It can influence the patients' management in a significant number of cases. Patients with negative 18F-FDG PET/CT findings had longer PFS than those with positive ones, but without statistical significance. SUVmax was not proven to be a strong predictor of patients' disease-free survival.

Objective: To evaluate Tc-99m-PSMA SPECT/CT detection of biochemical recurrence (BCR) of prostate cancer across serum PSA levels in patients treated with radical prostatectomy or radiation therapy, to explore clinical/pathologic predictors of scan positivity and metastatic disease, and to assess its potential role as a pragmatic alternative when PSMA PET/CT is unavailable in resource-limited settings. Materials and Methods: In this prospective single-center study, we included 132 men with biochemical recurrence who underwent Tc-99m-PSMA SPECT/CT between January 2024 and December 2025 after predefined inclusion and exclusion criteria were applied, and they were further stratified by primary treatment (radical prostatectomy or radiation therapy). Patients were followed up for up to 6 months after imaging to verify observed findings (histopathology, confirmatory imaging and PSA response) and a logistic regression was applied to identify predictors of scan positivity and metastatic disease. Results: In men initially treated with radical prostatectomy, detection increased from 38.9% at PSA 0.2 to <2 ng/mL to 63.2% at 2 to <4 ng/mL, 71.4% at 4 to <7 ng/mL, and 90% at PSA ≥ 7 ng/mL (overall 69.1%). In the radiation therapy cohort, detection was 58.3% at PSA 2 to <4 ng/mL, rising to 85.7% at 4 to <7 ng/mL and 96% at PSA ≥ 7 ng/mL (overall 84.3%). In the multivariable analysis, PSA doubling (log2[PSA]) independently predicted scan positivity and metastatic disease in both cohorts, while seminal vesicle invasion independently predicted metastatic spread in the post-prostatectomy group. Conclusions: Tc-99m-PSMA SPECT/CT is a useful tool for detecting prostate cancer BCR, with performance strongly dependent on PSA and higher detection in patients with higher PSA levels. Increasing PSA independently predicted scan positivity and metastatic disease, while seminal vesicle invasion was independently associated with metastatic spread. In settings where PSMA PET/CT is unavailable, Tc-99m-PSMA SPECT/CT may represent a practical alternative, particularly for patients with elevated PSA.

Introduction/Objective. The goal of our research was to evaluate diagnostic and prognostic role of positron emission tomography/computed tomography (PET-CT) in patients previously treated for uterine cancer and compare it to conventional imaging methods (CIM). Methods. We analyzed 37 patients examined on PET-CT for follow-up or suspicion of uterine cancer recurrence, and who were previously treated with surgery and/or chemoradiotherapy. All patients underwent CT or magnetic resonance imaging prior to PET-CT, and were followed-up for at least one year. Results. PET-CT showed sensitivity, specificity and diagnostic accuracy in uterine cancer relapse detection of 96.3%, 70%, and 89.2%, while those values for CIM were 92.6%, 40%, and 78.4 %, respectively. Correlation of PET-CT and CIM findings was 78% (29/37). In 13 out of 25 true positive patients on CIM, PET-CT found greater number of active sites missed by conventional imaging. Positive findings on PET-CT were associated with shorter progression free survival (p = 0.023, logrank test). Conclusion. PET-CT constitutes an important diagnostic method in management of recurrent cancer of uterine corpus, demonstrating high sensitivity and accuracy. In comparison to CIM, PET-CT can discover larger number of active tumor sites, and also shows better specificity. PET-CT positive patients have worse prognosis with shorter progression free survival.

Metabolic activity of breast cancer metastatic lesions on positron emission tomography/computed tomography: comparison with histological and biological characteristics of primary tumor

Introduction. The incidence of a second cancer among patients who have been treated for Hodgkin lymphoma (HL) is higher than the incidence of cancer in the general population. 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography / computed tomography is used in the evaluation of a number of malignancies. The aim of the article is to emphasize the importance of including a second primary cancer as a differential diagnosis among patients at risk. Case outline. We present a case of a patient diagnosed with two separate malignancies almost two decades after the treatment of HL. Conclusion. In patients previously treated for HL, a biopsy of lesions that show high 18F-FDG uptake should be advised, particularly if the location of the lesion is unusual for the primary diagnosis.