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Isolated mediastinal lymph node false positivity of [18F]-fluorodeoxyglucose-positron emission tomography/computed tomography in patients with cervical cancer.
- Source :
-
International journal of gynecological cancer : official journal of the International Gynecological Cancer Society [Int J Gynecol Cancer] 2013 Feb; Vol. 23 (2), pp. 337-42. - Publication Year :
- 2013
-
Abstract
- Objective: This study aimed to evaluate the degree of mediastinal involvement in patients with cervical cancer with isolated mediastinal [F]-fluorodeoxyglucose-positron emission tomography (FDG-PET) positivity as verified by histopathologic examination.<br />Methods: Two hundred twenty-eight patients with newly diagnosed cervical cancer and who underwent FDG-PET imaging were analyzed. Twenty-nine patients (17%) had disseminated disease detected with PET/computed tomography (CT). Only 10 patients (4%) had increased FDG uptake in mediastinal lymph nodes alone. Of the 10 patients with mediastinal disease, 2 refused surgical mediastinal lymph node biopsy and did not receive any treatment. Patients with suspected paratracheal or subcarinal lymph node metastasis detected on PET/CT underwent mediastinoscopy, and those with hilar metastasis had video-assisted mediastinal lymphadenectomy. Treatment was delivered according to final staging based on histopathologic confirmation of mediastinal lymph node involvement.<br />Results: The mean (SD) maximum standardized uptake values for primary cervical tumor and mediastinal lymph nodes were 19.7 (10.3) and 7.5 (1.6), respectively. Of 8 patients who underwent mediastinal lymph node confirmation, 6 (75%) were tumor free, demonstrating granulomatous changes, and were treated curatively. No patients had residual or recurrent disease at the primary site, and all but 1 were alive without disease. Two patients with confirmed mediastinal lymph node metastasis were treated palliatively and died between 9 and 11 months after diagnosis.<br />Conclusions: Positron emission tomography/CT is an important tool for lymphatic staging and evaluation of distant metastases in cervical cancer. However, PET/CT should be interpreted cautiously for isolated mediastinal involvement; surgical evaluation is required for accurate staging and appropriate treatment decisions to achieve better outcomes.
- Subjects :
- Aged
Aged, 80 and over
Carcinoma, Squamous Cell pathology
False Positive Reactions
Female
Humans
Lymph Node Excision methods
Lymphatic Metastasis
Mediastinal Neoplasms secondary
Mediastinoscopy
Mediastinum pathology
Middle Aged
Uterine Cervical Neoplasms pathology
Carcinoma, Squamous Cell diagnostic imaging
Fluorodeoxyglucose F18
Lymph Nodes diagnostic imaging
Mediastinal Neoplasms diagnostic imaging
Mediastinum diagnostic imaging
Multimodal Imaging
Positron-Emission Tomography
Tomography, X-Ray Computed
Uterine Cervical Neoplasms diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1525-1438
- Volume :
- 23
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
- Publication Type :
- Academic Journal
- Accession number :
- 23358181
- Full Text :
- https://doi.org/10.1097/IGC.0b013e31827e00cc