Long Axial Field-of-View PET/CT Could Answer Unmet Needs in Gynecological Cancers

SIMPLE SUMMARY: Recent advances in PET/CT technology led to the development of long-axial field-of-view (LAFOV) PET/CT with the possibility of simultaneously scanning a large portion of the body with reduced acquisition time, reduced radiation burden, and improved spatial resolution. This article explores the potential applications of LAFOV PET/CT imaging in gynecological malignancies. Patients affected by these diseases are expected to gain multiple and major benefits from this technology and have some of their unmet needs answered in all phases of management, from initial staging to surgery and radiotherapy planning, assessment of treatment response, and restaging, with improved patient-tailored care. ABSTRACT: Gynecological malignancies currently affect about 3.5 million women all over the world. Imaging of uterine, cervical, vaginal, ovarian, and vulvar cancer still presents several unmet needs when using conventional modalities such as ultrasound, computed tomography (CT), magnetic resonance, and standard positron emission tomography (PET)/CT. Some of the current diagnostic limitations are represented by differential diagnosis between inflammatory and cancerous findings, detection of peritoneal carcinomatosis and metastases <1 cm, detection of cancer-associated vascular complications, effective assessment of post-therapy changes, as well as bone metabolism and osteoporosis assessment. As a result of recent advances in PET/CT instrumentation, new systems now offer a long-axial field-of-view (LAFOV) to image between 106 cm and 194 cm (i.e., total-body PET) of the patient’s body simultaneously and feature higher physical sensitivity and spatial resolution compared to standard PET/CT systems. LAFOV PET could overcome the forementioned limitations of conventional imaging and provide valuable global disease assessment, allowing for improved patient-tailored care. This article provides a comprehensive overview of these and other potential applications of LAFOV PET/CT imaging for patients with gynecological malignancies.