¹⁸F-FDG PET/CT and sentinel lymph node biopsy in the staging of patients with cervical and endometrial cancer. Role of dual-time-point imaging

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• 作者：M. Mayoral^a ; ¹ ; ^{mmayoral@clinic.ub.es} ; P. Paredes^a ; ^b ; ¹ ; B. Domè ; nech^a ; P. Fusté ; ^c ; S. Vidal-Sicart^a ; ^b ; A. Tapias^a ; A. Torné ; ^b ; ^c ; J. Pahisa^b ; ^c ; J. Ordi^d ; ^e ; F. Pons^a ; ^b ; F. Lomeñ ; a^a ; ^b
• 关键词：Cervical cancer ; Endometrial cancer ; PET/CT ; Sentinel lymph node ; Dual-time-point imaging
• 刊名：Revista Española de Medicina Nuclear e Imagen Molecular
• 出版年：2017
• 出版时间：January-February 2017
• 年：2017
• 卷：36
• 期：1
• 页码：20-26
• 全文大小：1037 K
• 卷排序：36

文摘

Definitive staging for cervical (CC) and endometrial cancer (EC) takes place once surgery is performed. The aim of this study was to evaluate the role of PET/CT in detecting lymphatic metastasis in patients with CC and EC using dual-time-point imaging (DPI), taking the histopathological results of sentinel lymph node (SLN) and lymphadenectomy as the reference.Material and methodsA prospective study was conducted on 17 patients with early CC, and 13 patients with high-risk EC. The patients had a pre-operative PET/CT, MRI, SLN detection, and lymphadenectomy, when indicated. PET/CT findings were compared with histopathological results.ResultsIn the pathology study, 4 patients with CC and 4 patients with EC had lymphatic metastasis. PET/CT showed hypermetabolic nodes in 1 patient with CC, and 5 with EC. Four of these had metastasis, one detected in the SLN biopsy. Four patients who had negative PET/CT had micrometastasis in the SLN biopsy, 1 patient with additional lymph nodes involvement. The overall patient-based sensitivity, specificity, positive and negative predictive values, and accuracy of PET/CT to detect lymphatic metastasis was 20.0%, 100.0%, 100.0%, 87.9%, and 88.2%, respectively, in CC, and 57.1%, 88.9%, 66.7%, 84.2% and 80.0%, respectively, in EC. DPI showed higher retention index in malignant than in inflammatory nodes, although no statistically significant differences were found.ConclusionsPET/CT has low sensitivity in lymph node staging of CC and EC, owing to the lack of detection of micrometastasis. Thus, PET/CT cannot replace SLN biopsy. Although no statistically significant differences were found, DPI may help to differentiate between inflammatory and malignant nodes.