PET‐CT versus MRI in the diagnosis of lymph node metastasis of cervical cancer: A meta‐analysis

Author(s):  
Tao He ◽  
Jiangming Sun ◽  
Jie Wu ◽  
Hui Wang ◽  
Changping Liang ◽  
...  
2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 5587-5587
Author(s):  
J. Park ◽  
S. Seo ◽  
S. Kang ◽  
S. Lim ◽  
M. Lim ◽  
...  

5587 Background: Previosly, we reported the accuracy of positron emission tomography with 2-[fluorine18] fluoro-2-deoxy-D- glucose (FDG-PET) for detecting metastatic lymph node (LN) in cervical cancer (Eur J Cancer 2005: 41; 2086–92). The aim of this prospective study was to evaluate the accuracy of PET/CT for detecting lymph node metastasis in cervical cancer and to compare the accuracy between PET and PET/CT. Methods: From May 2002 to Jul 2006, 86 patients with untreated stage IB-IVA cervical cancer were enrolled. All patients underwent pretreatment clinical staging including PET (May 2002-Aug 2003, 54 patients) or PET/CT (Jan 2004-Jul 2006, 32 patients) followed by surgical staging including systematic pelvic and paraaortic lymph node (PLN and PALN) dissection. To enable region specific comparisons, PALN and PLN were divided into eight regions: both PALN, both common iliac areas, both external iliac areas, and both internal iliac/obturator areas. Each lymph node was sliced at 2-mm intervals perpendicular to the greatest dimension to maximize the likelihood of detecting micrometastases. All metastatic tumor size in each involved lymph node was measured. Histopathologic evaluation of lymph nodes was the diagnostic standard. The study protocol was approved by Institutioal Review Board, and a written informed consent was obtained. Results: A total of 688 LN regions were evaluated. The sensitivity, specificity, positive predictive value, and negative predictive value of PET and PET/CT are shown in Table 1 . As the metastatic tumor size increased, the sensitivity of PET and PET/CT was improved. Although there were no differences in sensitivity for detecting large sized (> 5mm or 10mm) metastatic tumor, PET/CT was more sensitive than PET for all pathologically proven LN metastasis which included small sized (< 5mm) metastatic tumor. Conclusions: PET/CT was more sensitive than PET for detecting small sized (<5mm) lymph node metastasis in cervical cancer. [Table: see text] No significant financial relationships to disclose.


2020 ◽  
Vol 30 (9) ◽  
pp. 1434-1443
Author(s):  
Alejandra Martinez ◽  
Martina Aida Angeles ◽  
Denis Querleu ◽  
Gwenael Ferron ◽  
Christophe Pomel

Para-aortic lymph node status at initial assessment is the most important prognostic factor and a key point for the therapeutic strategy in patients with locally advanced cervical cancer. Undiagnosed lymph node metastasis is a major clinical problem as the finding of positive para-aortic lymph nodes leads to treatment modification, with a possible impact on disease free survival. When aortic lymph node disease is discovered, radiotherapy is extended to the para-aortic area, and other treatment modalities may be considered. Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) is the most accurate imaging examination to assess para-aortic extension in patients with locally advanced cervical cancer. The gold standard to identify para-aortic extension remains histologic evaluation of the lymph nodes. Indeed, PET/CT fails to detect approximately 10–15% of patients with negative PET/CT aortic nodes who have lymph node metastasis on pathologic staging. Patients with positive pelvic lymph nodes have para-aortic extension in 25–30% of cases, and surgical staging will lead to treatment modification and probably to improved para-aortic and distant control. Surgical staging also avoids unnecessary toxicity associated with extended field radiation in approximately 75% of patients with pelvic lymph node metastasis. The best modality to identify para-aortic extension is histological evaluation of the lymph nodes, but the survival benefit of surgical staging remains controversial. On the other hand, current studies include a majority of patients without pelvic lymph node spread, who are likely to be those who will benefit the least from surgical staging.


Radiology ◽  
2006 ◽  
Vol 238 (1) ◽  
pp. 272-279 ◽  
Author(s):  
Sandro Sironi ◽  
Alessandro Buda ◽  
Maria Picchio ◽  
Patrizia Perego ◽  
Rossella Moreni ◽  
...  

2012 ◽  
Vol 103 ◽  
pp. S82
Author(s):  
H. Hansen ◽  
S. Engelholm ◽  
P. Munck af Rosenschold ◽  
S. Lassen ◽  
S.A. Engelholm

2016 ◽  
Vol 142 (3) ◽  
pp. 413-419 ◽  
Author(s):  
Mostafa Atri ◽  
Zheng Zhang ◽  
Farrokh Dehdashti ◽  
Susanna I. Lee ◽  
Shamshad Ali ◽  
...  

2020 ◽  
Author(s):  
Fan Guo ◽  
Wei na Kong ◽  
Gang Zhao ◽  
Zhen zhen Cheng ◽  
Le Ai ◽  
...  

Abstract Background: Tumor microenvironment (TME) plays a particularly important role in the progression, invasion and metastasis of cervical carcinoma (CC). Tumor-associated macrophages (TAMs) are significant components of cervical cancer microenvironment. However, the result of studies on the correlation between TAMs and progression in CC is still controversial. This research is aimed at investigating the relationship between TAMs and progression in CC.Method: A total of 100 patients with CC were included in this study. The correlation between TAMs and clinicopathologic features was studied. Also, a systematic literature search was conducted from legitimate electronic databases. This is the first meta-analysis to specifically evaluate the role of different types of TAMs in TME of cervical cancer.Results: In the meta-analysis, high stromal CD68+ TAMs density was relevant to lymph node metastasis (WMD = 11.89, 95% CI 5.30 to 18.47). At the same time, CD163+ M2 TAM density was associated with lymph node metastasis (OR = 2.42, 95% CI 1.09 to 5.37; WMD = 39.37, 95% CI 28.25 to 50.49) and International Federation of Obstetrics and Gynecology (FIGO) stage (WMD = -33.60, 95% CI -45.04 to -22.16). This was confirmed in 100 experimental studies of CC. It supported a critical role of TAMs as a prospective predictor for cervical cancer.Conclusion: Taken together, CD68+ TAM and CD163+ M2 TAM infiltration in cervical cancer was association with tumor progression. And CD163+ M2 TAM infiltration was associated with more advanced FIGO stage and lymph node metastasis in CC.


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