Article

Integrated PET/CT for the evaluation of para-aortic nodal metastasis in locally advanced cervical cancer patients with negative conventional CT findings.

Department of Gynecologic Oncology, Aegean Obstetrics and Gynecology Training and Research Hospital, Izmir, Turkey.
Gynecologic Oncology (impact factor: 3.89). 02/2008; 108(1):154-9. DOI:10.1016/j.ygyno.2007.09.011 pp.154-9
Source: PubMed

ABSTRACT The aim of this study was to evaluate the usefulness of integrated 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (PET/CT) for the detection of para-aortic nodal status and to test whether PET/CT change management strategy in locally advanced cervical cancer (LACC) patients with negative conventional CT findings.
Sixteen locally advanced (FIGO stage IIB-IVA) cervical squamous cancer patients with negative conventional CT findings were eligible to enter this prospective study. All patients underwent firstly PET/CT scans then extraperitoneal surgical exploration for para-aortic lymphadenectomy. Based on histopathologic confirmation, the accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the PET/CT for para-aortic lymph node metastasis were estimated.
The median age was 48.7 (range 42-67). The accuracy, sensitivity, specificity, PPV and NPV of the PET/CT were 75%, 50%, 83.3%, 50% and 83.3%, respectively. The treatment was modified in four of sixteen (25%) patients; four patients received EFRT in combination with cisplatin chemotherapy instead of standard pelvic field radiotherapy in combination with cisplatin chemotherapy.
Our results, despite our study group is small, suggest that PET/CT is an effective imaging technique in the evaluation of LACC with negative CT findings. It may help planning the management especially selecting radiation field. However, larger controlled studies are needed to recommend PET/CT as an alternative to pre-treatment surgical staging.

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Keywords

2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography
 
cisplatin chemotherapy
 
effective imaging technique
 
EFRT
 
FIGO stage IIB-IVA
 
larger
 
negative conventional CT findings
 
negative CT findings
 
negative predictive value
 
para-aortic lymph node metastasis
 
para-aortic lymphadenectomy
 
para-aortic nodal status
 
PET/CT
 
PET/CT change management strategy
 
PET/CT scans
 
positive predictive value
 
prospective study
 
standard pelvic field radiotherapy
 
study group
 
usefulness
 

Y Yildirim