scholarly journals Diagnostic performance of preoperative [18F]FDG-PET/CT for lymph node staging in vulvar cancer: a large single-centre study

2021 ◽  
Author(s):  
Vittoria Rufini ◽  
Giorgia Garganese ◽  
Francesco P. Ieria ◽  
Tina Pasciuto ◽  
Simona M. Fragomeni ◽  
...  
Keyword(s):  
Lymph Node ◽  
Quantitative Analysis ◽  
Fdg Pet ◽  
Diagnostic Performance ◽  
Vulvar Cancer ◽  
Visual Assessment ◽  
Single Centre ◽  
Pet Ct ◽  
Study Population ◽  
Fdg Pet Ct

Abstract Purpose This retrospective study aimed to assess the diagnostic performance of preoperative [18F]FDG-PET/CT in predicting the groin and pelvic lymph node (LN) status in a large single-centre series of vulvar cancer patients. Methods Between January 2013 and October 2018, among all consecutive women with proven vulvar cancer submitted to [18F]FDG-PET/CT, 160 patients were included. LNs were analysed by two qualitative methods assessing PET information (defined as visual assessment) and a combination of PET and low-dose CT information (defined as overall assessment), respectively, as well as semi-quantitative analysis (LN-SUVmax). Sensitivity, specificity, accuracy, positive and negative predictive values (PPV and NPV) in predicting the groin and pelvic LN status were calculated in the overall study population; a subset analysis of groin parameters in clinically/ultrasonography negative patients was also performed. Histopathology was the reference standard. Results All patients underwent vulvar and inguinofemoral LN surgery, and 35 pelvic LN surgery. Overall, 338 LN sites (296 groins and 42 pelvic sites) were histologically examined with 30.4% prevalence of metastatic groins and 28.6% for metastatic pelvic sites. In the overall study population, sensitivity (95% confidence interval, CI), specificity (95% CI), accuracy (95% CI), PPV (95% CI) and NPV (95% CI) at the groin level were 85.6% (78.3–92.8), 65.5% (59.0–72.0), 71.6% (66.5–76.8), 52.0% (44.0–60.1) and 91.2% (86.7–95.8) for visual assessment; 78.9% (70.5–87.3), 78.2% (72.5–83.8), 78.4% (73.7–83.1), 61.2% (52.3–70.1) and 89.4% (85.0–93.9) for overall assessment; and 73.3% (64.2–82.5), 85.0% (80.1–89.8), 81.4% (77.0–85.8), 68.0% (58.8–77.3) and 87.9% (83.4–92.5) for semi-quantitative analysis (SUVmax cut-off value 1.89 achieved by ROC analysis). Similar results were observed in the pelvis-based analysis. Conclusion In this large single-centre series of vulvar cancer patients, [18F]FDG-PET/CT showed good values of sensitivity and NPV in discriminating metastatic from non-metastatic LNs. In routine clinical practice, qualitative analysis is a reliable interpretative criterion making unnecessary commonly used semi-quantitative methods such as SUVmax.

Diagnostic performance of 18F-FDG PET/CT, ultrasonography and MRI

2014 ◽  
Vol 53 (03) ◽  
pp. 89-94 ◽  
Author(s):  
D. H. Lee ◽  
J.-K Yoon ◽  
S. J. Lee ◽  
T. H. Kim ◽  
D. K. Kang ◽  
...  
Keyword(s):  
Lymph Node ◽  
Fdg Pet ◽  
Axillary Lymph Node ◽  
Diagnostic Performance ◽  
Axillary Lymph ◽  
Diagnostic Ability ◽  
Node Metastasis ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

SummaryThe aim of this study was to evaluate the diagnostic abilities of 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) compared with those of ultrasonography and magnetic resonance imaging (MRI) for axillary lymph node staging in breast cancer patients. Patients, methods: Pre- operative 18F-FDG PET/non-contrast CT, ultrasonography and MRI were performed in 215 women with breast cancer. Axillary lymph node dissection was performed in all patients and the diagnostic performance of each modality was evaluated using histopathologic assessments as the reference standard. ROC curves were compared to evaluate the diagnostic ability of several imaging modalities (i. e., ultrasonography, MRI and 18F-FDG PET/CT). Results: In total, 132 patients (61.4%) had axillary lymph node metastasis. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for the detection of axillary lymph node metastasis were 72.3%, 77.3%, 66.7%, 81.6%, 75.3% for ultrasonography, 67.5%, 78.0%, 65.9%, 79.2%, 74.0% for MRI, and 62.7%, 88.6%, 77.6%, 79.1%, 78.6% for 18F-FDG PET/CT, respectively. There was no significant difference in diagnostic ability among the imaging modalities (i.e., ultrasonography, MRI and 18F-FDG PET/CT). The diagnostic ability of 18F-FDG PET/CT was significantly improved by combination with MRI (p = 0.0002) or ultrasonography (p < 0.0001). The combination of 18F-FDG PET/CT with ultrasonography had a similar diagnostic ability to that of all three modalities combined (18F-FDG PET/CT+ultraso- nography+MRI, p = 0.05). Conclusion: The diagnostic performance of 18F-FDG PET/CT for detection of axillary node metastasis was not significantly different from that of ultrasonography or MRI in breast cancer patients. Combining 18F-FDG PET/CT with ultrasonography or MRI could improve the diagnostic performance compared to 18F-FDG PET/CT alone.

scholarly journals Evaluation of Dual-Timepoint18F-FDG PET/CT Imaging for Lymph Node Staging in Vulvar Cancer

2017 ◽  
Vol 58 (12) ◽  
pp. 1913-1918 ◽  
Author(s):  
Angela Collarino ◽  
Giorgia Garganese ◽  
Renato A. Valdés Olmos ◽  
Antonella Stefanelli ◽  
Germano Perotti ◽  
...  
Keyword(s):  
Lymph Node ◽  
Fdg Pet ◽  
Vulvar Cancer ◽  
Ct Imaging ◽  
Lymph Node Staging ◽  
Pet Ct ◽  
Fdg Pet Ct

scholarly journals Comparison of 68Ga-DOTANOC and 18F-FDG PET-CT Scans in the Evaluation of Primary Tumors and Lymph Node Metastasis in Patients With Rectal Neuroendocrine Tumors

2021 ◽  
Vol 12 ◽  
Author(s):  
Zhihao Zhou ◽  
Zhixiong Wang ◽  
Bing Zhang ◽  
Yanzhang Wu ◽  
Guanghua Li ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Fdg Pet ◽  
Visual Assessment ◽  
Ct Scans ◽  
Primary Tumors ◽  
Node Metastasis ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

BackgroundLymph node metastasis of rectal neuroendocrine tumors (RNETs) predicts poor prognosis. However, the assessment of lymph node metastasis remains a challenge. It has been reported that 68Ga-DOTANOC and 18F-FDG PET-CT scans could be employed in the work-up of rectal neuroendocrine tumors (RNETs). This study aimed to assess both tracers’ ability to identify primary tumors and lymph node (LN) metastasis in RNETs.MethodsA total of 537 patients with RNETs were enrolled from January 2014 to January 2021. Both 68Ga-DOTANOC and 18F-FDG PET-CT scans were used to evaluate primary tumors and LN group metastasis. PET images were evaluated through visual and semiquantitative assessment. Receiver Operating Characteristics (ROC) curve analysis was used to investigate the performance of SUVmax of 68Ga-DOTANOC and 18F-FDG PET in predicting LN group metastasis.ResultsFifty-two patients with preoperative 68Ga-DOTANOC with 18F-FDG PET-CT scans underwent endoscopic biopsy or dissection of the primary tumor, while 11 patients underwent rectal surgery together with regional LN dissection. For primary tumors, 68Ga-DOTANOC had a sensitivity of 89.58% and a positive predictive value (PPV) of 95.56% through visual assessment, while 18F-FDG PET-CT showed 77.08% sensitivity and 97.37% PPV. For the prediction of LN group metastasis, 68Ga-DOTANOC PET-CT had 77.78% sensitivity and 91.67% specificity, while 18F-FDG PET-CT had 38.89% sensitivity and 100% specificity according to visual assessment. The area under the ROC curves (AUC) for 68Ga-DOTANOC PET/CT was 0.852 (95%CI:0.723-0.981) with an optimal SUVmax cut-off value of 2.25, while the AUC for 18F-FDG PET were 0.664 (95%CI:0.415-0.799) with an optimal SUVmax cut-off value of 1.05.ConclusionsThis study showed that 68Ga-DOTANOC PET-CT was a promising tool for detecting LN metastasis in RNETs with high sensitivity and specificity in visual assessment and semiquantitative assessment, which was better than 18F-FDG PET-CT.

Diagnostic Performance of 18F-FDG PET/CT for Lymph Node Staging in Patients with Operable Non-small-cell Lung Cancer and Inflammatory Lung Disease

Lung ◽  
2008 ◽  
Vol 186 (5) ◽  
pp. 327-336 ◽  
Author(s):  
Young-Sil An ◽  
Joo Sung Sun ◽  
Kyung Joo Park ◽  
Sung Chul Hwang ◽  
Kwang Joo Park ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Fdg Pet ◽  
Diagnostic Performance ◽  
Small Cell ◽  
Lymph Node Staging ◽  
Small Cell Lung ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

scholarly journals Diagnostic Performance of FDG-PET/CT Scan as Compared to US-Guided FNA in Prediction of Axillary Lymph Node Involvement in Breast Cancer Patients

2021 ◽  
Vol 11 ◽  
Author(s):  
Hazem I. Assi ◽  
Ibrahim A. Alameh ◽  
Jessica Khoury ◽  
Maroun Bou Zerdan ◽  
Vanessa Akiki ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Cancer Patients ◽  
Fdg Pet ◽  
Diagnostic Performance ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Fdg Uptake ◽  
Pet Ct ◽  
Fdg Pet Ct

PurposeThe aim of this study was to evaluate the diagnostic ability of 2-deoxy-2-[fluorine-18]fluoro-d-glucose (18F-FDG) PET/non-contrast CT compared with those of ultrasound (US)-guided fine needle aspiration (FNA) for axillary lymph node (ALN) staging in breast cancer patients.Patients and MethodsPreoperative 18F-FDG PET/non-contrast CT was performed in 268 women with breast cancer, as well as ALN dissection or sentinel lymph node (SLN) biopsy. One hundred sixty-four patients underwent US-guided FNA in combination with 18F-FDG PET/CT. The diagnostic performance of each modality was evaluated using histopathologic assessments as the reference standard. The receiver operating characteristic (ROC) curves were compared to evaluate the diagnostic ability of several imaging modalities.ResultsAxillary 18F-FDG uptake was positive in 180 patients, and 125 patients had axillary metastases according to the final pathology obtained by ALN dissection and/or SLN dissection. Of the patients with positive 18F-FDG uptake in the axilla, 21% had false-positive results, whereas 79% were truly positive. Eighty-eight patients had negative 18F-FDG uptake in the axilla, among which 25% were false-negative. 18F-FDG-PET/CT had a sensitivity of 86.59% and a specificity of 63.46% in the assessment of ALN metastasis; on the other hand, US-guided FNA had a sensitivity of 91.67% and a specificity of 87.50%. The mean primary cancer size (p = 0.04) and tumor grade (p = 0.04) in combination were the only factors associated with the accuracy of 18F-FDG PET/CT for detecting metastatic ALNs.ConclusionThe diagnostic performance of 18F-FDG PET/CT for the detection of axillary node metastasis in breast cancer patients was not significantly different from that of US-guided FNA. Combining 18F-FDG PET/CT with US-guided FNA or SLN biopsy could improve the diagnostic performance compared to 18F-FDG PET/CT alone.

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