False negative rate at 18F-FDG PET/CT in para-aortic lymphnode involvement in patients with locally advanced cervical cancer: impact of PET technology

BMC Cancer

Veronika Seebacher¹  Anna Ilenko¹  Amandine Maulard¹  Sebastien Gouy²  Philippe Morice²  Patricia Pautier³  Alexandra Leary³  Serena Grimaldi⁴  Marie Terroir⁴  Désirée Deandreis⁵  Catherine Genestie⁶  Cyrus Chargari⁷ 

[1] Department of Gynecologic Surgery, Gustave Roussy and Paris Saclay, 114 Rue Edouard Vaillant, Villejuif, France;Department of Gynecologic Surgery, Gustave Roussy and Paris Saclay, 114 Rue Edouard Vaillant, Villejuif, France;University Paris Sud, Orsay, France;Unit INSERM 1030, 114 Rue Edouard Vaillant, Villejuif, France;Department of Medical Oncology, Gustave Roussy and Paris Saclay, 114 Rue Edouard Vaillant, Villejuif, France;Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy and Paris Saclay, 114 Rue Edouard Vaillant, 94800, Villejuif, France;Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy and Paris Saclay, 114 Rue Edouard Vaillant, 94800, Villejuif, France;Department of Medical Sciences, Nuclear Medicine Division, the University of Turin, C.so Dogliotti, 14 10126, Turin, Italy;Department of Pathology, Gustave Roussy and Paris Saclay, 114 Rue Edouard Vaillant, Villejuif, France;University Paris Sud, Orsay, France;Department of Radiotherapy and Brachytherapy Unit, Gustave Roussy and Paris Saclay, 114 Rue Edouard Vaillant, Villejuif, France;Effets biologiques des rayonnements, Institut de Recherche Biomédicale des Armées, Bretigny-sur-Orge, France;

关键词: LACC;    Cervical cancer;    PET/CT;    TOF;    Para-aortic lymph node;    FDG;   

DOI  :  10.1186/s12885-021-07821-9

来源: Springer

【 摘 要 】

BackgroundThe identification of factors responsible for false negative (FN) rate at 18F- Fluorodeoxyglucose (FDG) Positron Emission Tomography /Computed Tomography (PET/CT) in para-aortic (PA) lymph nodes in the presurgical staging of patients with locally advanced cervical cancer (LACC) is challenging. The aim of this study was to evaluate the impact of PET/CT technology.MethodsA total of 240 consecutive patients with LACC (International Federation of Gynecology and Obstetrics, FIGO, stage IB2-IVA) and negative Magnetic Resonance Imaging (MRI) and/or Computed Tomography (CT) and negative 18F-FDG PET/CT in the PA region, undergoing laparoscopic PA lymphadenectomy before chemoradiotherapy were included. The FN rate in patients studied with Time of flight (TOF) PET/CT (TOF PET) or non-Time of flight PET/CT (no-TOF PET) technology was retrospectively compared.ResultsPatients presented with FIGO stage IB (n = 78), stage IIA-B (n = 134), stage III (n = 18) and stage IVa (n = 10), squamous cell carcinoma (n = 191) and adenocarcinoma (n = 49). 141/240 patients were evaluated with no-TOF PET/CT and 99/240 with TOF PET/CT. Twenty-two patients (9%) had PA nodal involvement at histological analysis and considered PET/CT FN findings. The FN rate was 8.5% for no-TOF PET and 10% for TOF PET subgroup respectively (p = 0.98). Ninety patients (38%) presented with pelvic node uptakes at PET/CT. The FN rate in the PA region was 18% (16/90) and 4% (6/150) in patients with and without pelvic node involvement at PET/CT respectively (19 vs 3% for no-TOF PET and 17 vs 5% for TOF PET subgroup).ConclusionsIn LACC, FN rate in PA lymph nodes detection is a clinical issue even for modern PET/CT, especially in patients with pelvic uptake. Surgical lymphadenectomy should be performed in case of negative PET/CT at PA level in these patients, while it could be discussed in the absence of pelvic uptake.

【 授权许可】

CC BY