Background/Objectives: Endometrial cancer (EC) is the most common gynecological tumor in developed countries, and presents a wide variety of histological and molecular characteristics that make its treatment increasingly complex. In recent years, advances in molecular imaging, particularly with [18F]FDG-PET/CT and PET/MRI, have changed clinicians’ management of diagnosis, treatment planning, and prognosis of EC.Methods: In this narrative review, a search was conducted for current evidence on the role of [18F]FDG-PET/CT and PET/MRI throughout the treatment of EC, focusing on their diagnostic performance, clinical relevance, and prognostic implications. Their use in areas such as initial staging, treatment monitoring, recurrence detection, and individualized risk assessment was also discussed.Results: [18F]FDG-PET/CT is effective in detecting lymph node and distant metastases, while [18F]FDG-PET/MRI offers greater accuracy for T and N staging. In addition, [18F]FDG-PET/CT provides early metabolic indicators of therapeutic response and facilitates differentiation between viable tumors and post-treatment changes. Radiomics-derived parameters have shown promising associations with tumor aggressiveness and lymphovascular invasion and survival, supporting their role as prognostic imaging biomarkers. In addition, the use of non-FDG radiotracers, as well as predictive models based on machine learning, can further refine preoperative stratification and treatment planning in certain subtypes of EC.Conclusions: Molecular imaging enhances the accuracy of TNM staging in EC. The incorporation of molecular imaging biomarkers into daily clinical practice could significantly improve personalized decision-making in EC. However, large prospective studies are needed to confirm their efficacy.
背景/目的：子宫内膜癌是发达国家最常见的妇科肿瘤，其组织学和分子特征具有高度异质性，导致治疗日益复杂。近年来分子影像学技术（特别是[18F]FDG-PET/CT与PET/MRI）的发展，显著改变了临床医生对子宫内膜癌的诊断、治疗规划和预后评估策略。方法：本叙述性综述系统检索了当前关于[18F]FDG-PET/CT与PET/MRI在子宫内膜癌全程治疗中作用的证据，重点关注其诊断效能、临床相关性及预后价值，并探讨了其在初始分期、疗效监测、复发检测及个体化风险评估等领域的应用。结果：[18F]FDG-PET/CT能有效检测淋巴结及远处转移，而[18F]FDG-PET/MRI在T/N分期方面具有更高准确性。此外，[18F]FDG-PET/CT可提供早期代谢性疗效指标，有助于鉴别存活肿瘤与治疗后改变。影像组学参数与肿瘤侵袭性、淋巴血管侵犯及生存期存在显著关联，可作为预后影像生物标志物。非FDG示踪剂的应用及基于机器学习的预测模型，可进一步优化特定亚型子宫内膜癌的术前分层与治疗规划。结论：分子影像技术提高了子宫内膜癌TNM分期的准确性。将分子影像生物标志物纳入临床实践可显著改善个体化决策，但仍需大规模前瞻性研究验证其效能。
肿瘤(癌症)患者之家