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Evaluation of Dual-Timepoint 18 F-FDG PET/CT Imaging for Lymph Node Staging in Vulvar Cancer.
- Source :
-
Journal of nuclear medicine : official publication, Society of Nuclear Medicine [J Nucl Med] 2017 Dec; Vol. 58 (12), pp. 1913-1918. Date of Electronic Publication: 2017 May 25. - Publication Year :
- 2017
-
Abstract
- This study aimed to assess the value of dual-timepoint <superscript>18</superscript> F-FDG PET/CT in the prediction of lymph node (LN) status in patients with invasive vulvar cancer (VC) scheduled for inguinofemoral LN dissection. Methods: From April 2013 to July 2015, all consecutive patients with VC scheduled for inguinofemoral LN dissection were prospectively enrolled. All patients underwent a preoperative whole-body <superscript>18</superscript> F-FDG PET/CT scan at 1 h (standard examination) and an additional scan from T11 to the groins at 3 h (delayed examination) after <superscript>18</superscript> F-FDG injection. On both scans, each groin was visually scored 0 or 1 concerning <superscript>18</superscript> F-FDG LN uptake relative to background. Semiquantitative analysis included SUV <subscript>max</subscript> and the corresponding retention index of SUV <subscript>max</subscript> , measured on both scans. The optimal cutoff value of these parameters was defined using a receiver-operating-characteristic analysis. Histopathology was the standard of reference. Results: Thirty-three patients were included, with a total of 57 groins dissected and histologically evaluated. At histopathology, 21 of 57 (37%) groins contained metastatic LNs. Concerning visual score, sensitivity, specificity, negative predictive value, positive predictive value, and accuracy were 95.2%, 75%, 96.4%, 69%, and 82.5% on standard scanning and 95.2%, 77.8%, 96.6%, 71.4%, and 84.2% on delayed scanning, respectively. At receiver-operating-characteristic analysis, sensitivity and specificity were 95.2% and 77.8% on standard and delayed <superscript>18</superscript> F-FDG PET/CT for an SUV <subscript>max</subscript> cutoff of greater than 1.32 and 1.88, respectively, and 95.2% and 80% for a retention index of SUV <subscript>max</subscript> cutoff of greater than 0. Conclusion: Standard <superscript>18</superscript> F-FDG PET/CT is an effective preoperative imaging method for the prediction of LN status in VC, allowing the prediction of pathologically negative groins and thus the selection of patients suitable for minimally invasive surgery. Delayed <superscript>18</superscript> F-FDG PET/CT did not improve the specificity and the positive predictive value in our series. Larger studies are needed for a further validation.<br /> (© 2017 by the Society of Nuclear Medicine and Molecular Imaging.)
- Subjects :
- Aged
Female
Fluorodeoxyglucose F18
Groin diagnostic imaging
Humans
Image Processing, Computer-Assisted
Longitudinal Studies
Lymph Nodes pathology
Lymphatic Metastasis
Middle Aged
Predictive Value of Tests
Prospective Studies
Radiopharmaceuticals
Vulvar Neoplasms pathology
Whole Body Imaging
Lymph Nodes diagnostic imaging
Neoplasm Staging methods
Positron Emission Tomography Computed Tomography methods
Vulvar Neoplasms diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1535-5667
- Volume :
- 58
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Journal of nuclear medicine : official publication, Society of Nuclear Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 28546331
- Full Text :
- https://doi.org/10.2967/jnumed.117.194332