A comparison of 18F-FDG PET/CT findings in HIV positive compared to HIV negative patients with recurrent cervical cancer.

OBJECTIVE: HIV-positive women with cervical cancer have higher recurrence and death rates with shorter time to recurrence and death compared with HIV-negative subjects. The objective of this study was to compare the recurrence patterns in HIV-positive women with invasive cervical cancer to their HIV-negative counterparts using 18F-FDG PET/CT. SUBJECTS AND METHODS: We evaluated 40 HIV- seropositive and 79 HIV-seronegative patients with recurrent cervical carcinoma using 18F-FDG PET/CT. The PET/CT datasets were interpreted by two independent readers blinded to the HIV status of the patients. Areas of disagreement were resolved by consensus. Cervical cancer recurrence was confirmed by biopsy and histological examination of tissue, correlation with conventional imaging (CT and MRI) and by follow-up 18F-FDG PET/CT. RESULTS: HIV-positive patients were 9 years younger than the HIV-negative patients at the time of diagnosis; mean age 39 years versus 48 years respectively. Initial treatment was comparable in both groups. Time to recurrence was shorter in HIV-infected compared with HIV-uninfected women (11 versus 24 months). The commonest sites of metastatic recurrence was in the lymph nodes. HIV-infected patients demonstrated significant higher recurrence in lymph nodes and lungs (P 0.05) between both groups. HIV-infected patients showed unusual metastases to brain, spleen and skin. CONCLUSION: By using the 18F-FDG PET/CT scan we showed that the time to recurrence is shorter among HIV seropositive patients with the commonest site of metastatic recurrence being in the lymph nodes. Nodal and liver metastases are significantly higher in HIV seropositive patients compared with seronegative patients.