Feasibility, Safety and Impact of (18F)-FDG PET/CT in patients with pregnancy-associated cancer: experience of the French CALG (Cancer Associé à La Grossesse) network

Authors

  • Marie Despierres Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, Paris, France
  • Anne-Sophie Boudy Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, Paris, France; Cancer Associé à La Grossesse (CALG), French CALG Network, Paris, France
  • Lise Selleret Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, Paris, France; Cancer Associé à La Grossesse (CALG), French CALG Network, Paris, France
  • Joseph Gligorov Department of Oncology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, Paris, France; UMRS-938 4. Faculté de Médecine Sorbonne Université, Paris, France
  • Sandrine Richard Department of Oncology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, Paris, France; UMRS-938 4. Faculté de Médecine Sorbonne Université, Paris, France
  • Isabelle Thomassin UMRS-938 4. Faculté de Médecine Sorbonne Université, Paris, France; Department of Radiology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, Paris, France
  • Yohann Dabi Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, Paris, France; Cancer Associé à La Grossesse (CALG), French CALG Network, Paris, France
  • Sonia Zilberman Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, Paris, France; Cancer Associé à La Grossesse (CALG), French CALG Network, Paris, France
  • Cyril Touboul Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, Paris, France; Cancer Associé à La Grossesse (CALG), French CALG Network, Paris, France; UMRS-938 4. Faculté de Médecine Sorbonne Université, Paris, France
  • Françoise Montravers UMRS-938 4. Faculté de Médecine Sorbonne Université, Paris, France; Department of Nuclear Medicine, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, Paris, France
  • Kerrou Khaldoun UMRS-938 4. Faculté de Médecine Sorbonne Université, Paris, France; Department of Nuclear Medicine, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, Paris, France
  • Emile Darai Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, Paris, France; Cancer Associé à La Grossesse (CALG), French CALG Network, Paris, France; UMRS-938 4. Faculté de Médecine Sorbonne Université, Paris, France

DOI:

https://doi.org/10.1080/0284186X.2021.2004323

Keywords:

Pregnancy-associated cancer, pregnancy, imaging, PET/scan, Positon Emission Tomography, fetal outcomes

Abstract

Background

The incidence of pregnancy-associated cancers has been increasing for decades. (18F)-FDG Positron Emission Tomography (PET)/Computed Tomography (CT) imaging has become a golden standard in the staging of many malignant diseases. The aims of the current study were to evaluate the feasibility, safety and impact of (18F)-FDG PET/CT performed during pregnancy.

Material and methods

A retrospective analysis from the prospective database of the Cancer Associé à La Grossesse (CALG) network (Tenon Hospital, France) including patients who underwent (18F)-FDG PET/CT during their pregnancy between 2015 and 2020.

Results

Of the 536 patients for whom advice from the CALG network was requested during the study period, 359 were diagnosed with cancer during pregnancy. Study population was composed of 63 (17.5%) patients who underwent (18F)-FDG PET/CT. Most cancers were diagnosed during the second trimester. Seventy-five percent were diagnosed with breast cancer, mostly locally advanced invasive ductal carcinomas. Median term of pregnancy at PET/CT was 24.8 weeks of gestation. Twelve (19%), 24 (38.1%) and 22 (34.9%) patients underwent the exam during the 1st, 2nd and 3rd trimester, respectively. (18F)-FDG PET/CT resulted in stage modification for 38 (60.3%) of the patients (28 with more extensive lymph node involvement and 10 with metastatic disease) with subsequently/accordingly modified first-line medical treatment. Fifty patients gave birth to healthy newborns. Two patients had a medical termination of pregnancy, five had a medical abortion, one neonatal death occurred in a patient with severe preeclampsia (unrelated to (18F)-FDG PET/CT). The data of 46 children were available at 6 months, 29 at 12 months, and 15 at 24 months. No cases of mental retardation, childhood cancer, or malformation were reported within 2 years.

Conclusion

(18F)-FDG PET/CT has a major impact on the management of pregnancy-associated cancers and does not appear to cause fetal side effects suggesting that the exam is feasible during pregnancy as maternal benefits outweigh fetal risks.

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Published

2022-03-04

How to Cite

Despierres, M., Boudy, A.-S., Selleret, L., Gligorov, J., Richard, S., Thomassin, I., … Darai, E. (2022). Feasibility, Safety and Impact of (18F)-FDG PET/CT in patients with pregnancy-associated cancer: experience of the French CALG (Cancer Associé à La Grossesse) network. Acta Oncologica, 61(3), 302–308. https://doi.org/10.1080/0284186X.2021.2004323

Issue

Vol. 61 No. 3 (2022): Acta Oncologica

Section

Articles