105 PET-CT findings in HIV-positive and negative patients with locally advanced cervical cancer in a south african cohort

Objectives PET-CT imaging is commonly used as a staging tool to identify nodal involvement in locally advanced cervical carcinoma (LACC). The value of PET-CT for staging HIV-infected patients with locally advanced CC has not been previously described. We analyzed PET-CT findings in a cohort of patients with LACC in Cape Town, SA. Methods Patients with LACC FIGO Stage IIb or IIIB, and were referred, on the basis of stage and the availability of bookings, for PET-CT/radiotherapy planning CT from January 2015 to December 2018. A team of expert nuclear medicine physicians and radiologists reported the PET-CT examinations. Descriptive statistics and chi-squared tests were used to compare patients with and without HIV. Results A total of 286 patients underwent PET-CT. Eighty-nine patients (31.2%) were HIV-positive. Pelvic nodal involvement was notably found in 205 patients (72.4%), including 77.3% of those who had HIV and 70.3% of those who did not (p=0.22); para-aortic nodal disease in 114 patients (42.7% of HIV+ vs 38.8% HIV-, p=0.53); and distant disease in 55 patients (23.6% of HIV+ vs 17.3% HIV-; p=0.22). In total, 223 patients (79.3%), including 81.8% of patients without and 75.0% of patients with HIV (p=0.31), were prescribed standard fractionation EBRT. Twenty-two patients (7.8%) were prescribed hypofractionated EBRT, and 36 patients (12.8%) palliative therapy. Five patients (1.7%) did not return. Conclusions PET-CT imaging found no differences between LACC patients, with and without HIV, in nodal involvement or occult metastases and did not lead to, or justify, treatment differences.