scholarly journals Assessment of Lymph Node Involvement with PET-CT in Advanced Epithelial Ovarian Cancer. A FRANCOGYN Group Study

2021 ◽  
Vol 10 (4) ◽  
pp. 602
Author(s):  
Antoine Tardieu ◽  
Lobna Ouldamer ◽  
François Margueritte ◽  
Lauranne Rossard ◽  
Aymeline Lacorre ◽  
...  

The objective of our study is to evaluate the diagnostic performance of positron emission tomography/computed tomography (PET-CT) for the assessment of lymph node involvement in advanced epithelial ovarian, fallopian tubal or peritoneal cancer (EOC). This was a retrospective, bicentric study. We included all patients over 18 years of age with a histological diagnosis of advanced EOC who had undergone PET-CT at the time of diagnosis or prior to cytoreduction surgery with pelvic or para-aortic lymphadenectomy. We included 145 patients with primary advanced EOC. The performance of PET-CT was calculated from the data of 63 patients. The sensitivity of PET-CT for preoperative lymph node evaluation was 26.7%, specificity was 90.9%, PPV was 72.7%, and NPV was 57.7%. The accuracy rate was 60.3%, and the false-negative rate was 34.9%. In the case of primary cytoreduction (n = 16), the sensitivity of PET-CT was 50%, specificity was 87.5%, PPV was 80%, and NPV was 63.6%. The accuracy rate was 68.8%, and the false negative rate was 25%. After neoadjuvant chemotherapy (n = 47), the sensitivity of PET-CT was 18.2%, specificity was 92%, PPV was 66.7%, and NPV was 56.1%. The accuracy rate was 57.5%, and the false negative rate was 38.3%. Due to its high specificity, the performance of a preoperative PET-CT scan could contribute to the de-escalation and reduction of lymphadenectomy in the surgical management of advanced EOC in a significant number of patients free of lymph node metastases.

2009 ◽  
Vol 19 (1) ◽  
pp. 8-12 ◽  
Author(s):  
Stéphanie Motton ◽  
Thomas De Lapparent ◽  
Isabelle Brenot-Rossi ◽  
Max Buttarelli ◽  
Maryam Al Nakib ◽  
...  

Introduction:The aim of this study was to compare 18 fluoro-2deoxy-d-glucose-positron emission tomography (FDG-PET) after chemoradiation to histological findings after lymphadenectomy and radical hysterectomy and thus evaluate if FDG-PET could avoid surgery when negative.Methods:Twenty-one patients with locally advanced cervical cancer treated by chemoradiation, brachytherapy, and adjuvant surgery were prospectively enrolled. 18 Fluoro-2deoxy-d-glucose-PET was realized 5 weeks after concomitant chemoradiation and compared with histology.Results:18 Fluoro-2deoxy-d-glucose-PET assessed residual cervical involvement after chemoradiation with a sensitivity of 27.3%, specificity of 90%, and positive predictive value (PPV) of 75%. The negative predictive value (NPV) and the false-negative rate (FN) were 50%. Among patients with no evidence of disease on FDG-PET but with residual involvement on histology, 75% had residual involvement size under10 mm.For residual pelvic lymph node involvement, the specificity was 100%, NPV was 83.3%, and FN rate was 16.7%.For residual paraaortic lymph node involvement, specificity and sensitivity were 100%, but only 1 patient was concerned. Considering all the lymph node locations, sensitivity was 20%, specificity 100%, PPV 100%, and NPV 90%.Considering all localizations for each patient, control FDG-PET had a 30% sensitivity, 87% specificity, 80% PPV, and 43% NPV. False-negative rate was 43%.Conclusion:The aim of this study was to evaluate if control FDG-PET might avoid surgery for patients with a negative screening. Although FDG-PET is an interesting diagnostic test for residual lymph node involvement evaluation, it seems not accurate enough to be the only element of the surgery's indication. However, our sample size was too small to definitely conclude.


2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
E Johnston ◽  
S Taylor ◽  
F Bannon ◽  
S McAllister

Abstract Introduction and Aims The aim of this systematic review is to provide an up-to-date evaluation of the role and test performance of sentinel lymph node biopsy (SLNB) in the head and neck. Method This review follows the PRISMA guidelines. Database searches for MEDLINE and EMBASE were constructed to retrieve human studies published between 1st January 2010 and 1st July 2020 assessing the role and accuracy of sentinel lymph node biopsy in cutaneous malignant melanoma of the head and neck. Articles were independently screened by two reviewers and critically appraised using the MINORS criteria. The primary outcomes consisted of the sentinel node identification rate and test-performance measures, including the false-negative rate and the posttest probability negative. Results A total of 27 studies, including 4688 patients, met the eligibility criteria. Statistical analysis produced weighted summary estimates for the sentinel node identification rate of 97.3% (95% CI, 95.9% to 98.6%), the false-negative rate of 21.3% (95% CI, 17.0% to 25.4%) and the posttest probability negative of 4.8% (95% CI, 3.9% to 5.8%). Discussion Sentinel lymph node biopsy is accurate and feasible in the head and neck. Despite technical improvements in localisation techniques, the false negative rate remains disproportionately higher than for melanoma in other anatomical sites.


2012 ◽  
Vol 127 (3) ◽  
pp. 462-466 ◽  
Author(s):  
David Cibula ◽  
Nadeem R. Abu-Rustum ◽  
Ladislav Dusek ◽  
Jiri Slama ◽  
Michal Zikán ◽  
...  

2020 ◽  
Author(s):  
chenxi yuan ◽  
xinzhao wang ◽  
zhaoyun liu ◽  
chao li ◽  
mengxue bian ◽  
...  

Abstract Background Sentinel lymph node biopsy (SLNB) acts as a vital role in the breast cancer surgery, and the identified number of sentinel nodes determines its accuracy to represent the status of axillae. There remain two tumor biopsy modes in breast cancer, preoperative and intraoperative biopsy. We compared the effect of the two different biopsies on the result of SLNB. Methods Patients with clinical stage T1-3, N0 tumor were enrolled in this study. 53% received preoperative tumor biopsy and 47% received intraoperative excisional biopsy. For search of the sentinel lymph node, patients received dual tracer injection. The number of SLNs detected and false negative rate were compared between groups. Results 204 patients were enrolled, 108 received preoperative tumor biopsy and 96 received intraoperative excisional biopsy. Among all the patients, 160 received ALND following SLNB. Preoperative tumor biopsy detected more SLNs than intraoperative biopsy (mean rank 113.87 vs. 90.9, p= 0.004). False negative rate in preoperative and intraoperative tumor biopsy was 3% and 18%, respectively. Conclusions Patients in preoperative tumor biopsy group could find more SLNs than intraoperative biopsy patients. False negative rate was also lower in preoperative biopsy group.


Sign in / Sign up

Export Citation Format

Share Document