A woman in her twenties with cervical cancer underwent conical resection at 13 weeks gestation. The pathological examination showed lymphatic invasion and possible positive margins. A total hysterectomy was recommended; however, the patient strongly desired continuation of the pregnancy. An FDG-PET/MRI was performed at 16 and 27 weeks gestation for cancer staging. No evidence of metastasis was observed. The patient’s cancer treatment was delayed until fetal maturity, and a scheduled cesarean section was performed at 30 weeks gestation followed by a modified radical hysterectomy, oophorectomy, and pelvic lymph node dissection with ovarian preservation. Cervical intraepithelial neoplasia was diagnosed 18 months postoperatively and was treated via vaginal wall resection at 19 months postoperatively.
PET/MRI obtains PET and MR images simultaneously and the fused images provide information regarding anatomical and functional relationships. The high contrast resolution of MRI and the functional information provided by PET images render PET/MRI an ideal method for the evaluation of physiological FDG uptake by the fetus.
In this study, we could follow the physiological uptake of FDG by a fetus over time during the gestational weeks by PET/MRI. The FDG uptake by the fetal brain is lower than that in the maternal brain, and the FDG uptake is similar in the left and right cardiac ventricles. In addition, the physiological uptake by the tonsilla, liver, kidneys, and bladder, is reported.
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