Evaluation of dual-timepoint18F-FDG PET/CT imaging for lymph node staging in vulvar cancer

Giorgia Garganese, Giovanni Scambia, Alessandro Giordano, Vittoria Rufini, Angela Collarino, Antonella Stefanelli, Germano Perotti, Paoletta Mirk Fileni, Simona Maria Fragomeni, Francesco Pio Ieria, Renato A. Valdés Olmos

Risultato della ricerca: Contributo in rivistaArticolo in rivista

14 Citazioni (Scopus)

Abstract

This study aimed to assess the value of dual-timepoint18F-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-body18F-FDG PET/CT scan at 1 h (standard examination) and an additional scan from T11 to the groins at 3 h (delayed examination) after18F-FDG injection. On both scans, each groin was visually scored 0 or 1 concerning18F-FDG LN uptake relative to background. Semiquantitative analysis included SUVmaxand the corresponding retention index of SUVmax, measured on both scans. The optimal cutoff value of these parameters was defined using a receiveroperating- 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 delayed18F-FDG PET/CT for an SUVmaxcutoff of greater than 1.32 and 1.88, respectively, and 95.2% and 80% for a retention index of SUVmaxcutoff of greater than 0. Conclusion: Standard18F-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. Delayed18F-FDG PET/CT did not improve the specificity and the positive predictive value in our series. Larger studies are needed for a further validation.
Lingua originaleEnglish
pagine (da-a)1913-1918
Numero di pagine6
RivistaTHE JOURNAL OF NUCLEAR MEDICINE
Volume58
DOI
Stato di pubblicazionePubblicato - 2017

Keywords

  • 18F-FDG
  • Aged
  • Dual time point PET/CT
  • FDG-retention index
  • Female
  • Fluorodeoxyglucose F18
  • Groin
  • Groin lymph node metastasis
  • Humans
  • Image Processing, Computer-Assisted
  • Longitudinal Studies
  • Lymph Nodes
  • Lymphatic Metastasis
  • Middle Aged
  • Neoplasm Staging
  • Positron Emission Tomography Computed Tomography
  • Predictive Value of Tests
  • Prospective Studies
  • Radiology, Nuclear Medicine and Imaging
  • Radiopharmaceuticals
  • Vulvar Neoplasms
  • Vulvar cancer
  • Whole Body Imaging

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