Angela Collarino1,2, Giorgia Garganese3, Renato A Valdés Olmos2,4,5, Antonella Stefanelli6, Germano Perotti6, Paoletta Mirk7, Simona M Fragomeni3, Francesco P Ieria6, Giovanni Scambia3, Alessandro Giordano6, Vittoria Rufini6. 1. Institute of Nuclear Medicine, Università Cattolica del Sacro Cuore-Fondazione Policlinico A. Gemelli, Rome, Italy angelacollarino@tiscali.it. 2. Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands. 3. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore-Fondazione Policlinico A. Gemelli, Rome, Italy. 4. Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands. 5. Department of Nuclear Medicine, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands; and. 6. Institute of Nuclear Medicine, Università Cattolica del Sacro Cuore-Fondazione Policlinico A. Gemelli, Rome, Italy. 7. Department of Radiology, Università Cattolica del Sacro Cuore-Fondazione Policlinico A. Gemelli, Rome, Italy.
Abstract
This study aimed to assess the value of dual-timepoint 18F-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 18F-FDG PET/CT scan at 1 h (standard examination) and an additional scan from T11 to the groins at 3 h (delayed examination) after 18F-FDG injection. On both scans, each groin was visually scored 0 or 1 concerning 18F-FDG LN uptake relative to background. Semiquantitative analysis included SUVmax and the corresponding retention index of SUVmax, 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 18F-FDG PET/CT for an SUVmax cutoff of greater than 1.32 and 1.88, respectively, and 95.2% and 80% for a retention index of SUVmax cutoff of greater than 0. Conclusion: Standard 18F-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 18F-FDG PET/CT did not improve the specificity and the positive predictive value in our series. Larger studies are needed for a further validation.
This study aimed to assess the value of dual-timepoint 18F-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 18F-FDG PET/CT scan at 1 h (standard examination) and an additional scan from T11 to the groins at 3 h (delayed examination) after 18F-FDG injection. On both scans, each groin was visually scored 0 or 1 concerning 18F-FDG LN uptake relative to background. Semiquantitative analysis included SUVmax and the corresponding retention index of SUVmax, 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 18F-FDG PET/CT for an SUVmax cutoff of greater than 1.32 and 1.88, respectively, and 95.2% and 80% for a retention index of SUVmax cutoff of greater than 0. Conclusion: Standard 18F-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 18F-FDG PET/CT did not improve the specificity and the positive predictive value in our series. Larger studies are needed for a further validation.
Authors: Matthias Weissinger; Stefan Kommoss; Johann Jacoby; Stephan Ursprung; Ferdinand Seith; Sascha Hoffmann; Konstantin Nikolaou; Sara Yvonne Brucker; Christian La Fougère; Helmut Dittmann Journal: J Clin Med Date: 2022-08-23 Impact factor: 4.964
Authors: Angela Collarino; Giorgia Garganese; Simona M Fragomeni; Lenka M Pereira Arias-Bouda; Francesco P Ieria; Ronald Boellaard; Vittoria Rufini; Lioe-Fee de Geus-Oei; Giovanni Scambia; Renato A Valdés Olmos; Alessandro Giordano; Willem Grootjans; Floris H P van Velden Journal: J Nucl Med Date: 2018-07-20 Impact factor: 10.057
Authors: Vittoria Rufini; Giorgia Garganese; Francesco P Ieria; Tina Pasciuto; Simona M Fragomeni; Benedetta Gui; Anita Florit; Frediano Inzani; Gian Franco Zannoni; Giovanni Scambia; Alessandro Giordano; Angela Collarino Journal: Eur J Nucl Med Mol Imaging Date: 2021-02-23 Impact factor: 9.236