False negative rate at 18F-FDG PET/CT in para-aortic lymphnode involvement in patients with locally advanced cervical cancer: impact of PET technology
Abstract Background The 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) i...
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| Format: | Article |
| Language: | English |
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BMC
2021-02-01
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| Series: | BMC Cancer |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12885-021-07821-9 |
| _version_ | 1818459682590687232 |
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| author | Sebastien Gouy Veronika Seebacher Cyrus Chargari Marie Terroir Serena Grimaldi Anna Ilenko Amandine Maulard Catherine Genestie Alexandra Leary Patricia Pautier Philippe Morice Désirée Deandreis |
| author_facet | Sebastien Gouy Veronika Seebacher Cyrus Chargari Marie Terroir Serena Grimaldi Anna Ilenko Amandine Maulard Catherine Genestie Alexandra Leary Patricia Pautier Philippe Morice Désirée Deandreis |
| author_sort | Sebastien Gouy |
| collection | DOAJ |
| description | Abstract Background The 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. Methods A 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. Results Patients 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). Conclusions In 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. |
| first_indexed | 2024-12-14T23:18:14Z |
| format | Article |
| id | doaj.art-4feb1985996b4c349909fae83cb1ada7 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-14T23:18:14Z |
| publishDate | 2021-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-4feb1985996b4c349909fae83cb1ada72022-12-21T22:44:02ZengBMCBMC Cancer1471-24072021-02-012111910.1186/s12885-021-07821-9False negative rate at 18F-FDG PET/CT in para-aortic lymphnode involvement in patients with locally advanced cervical cancer: impact of PET technologySebastien Gouy0Veronika Seebacher1Cyrus Chargari2Marie Terroir3Serena Grimaldi4Anna Ilenko5Amandine Maulard6Catherine Genestie7Alexandra Leary8Patricia Pautier9Philippe Morice10Désirée Deandreis11Department of Gynecologic Surgery, Gustave Roussy and Paris SaclayDepartment of Gynecologic Surgery, Gustave Roussy and Paris SaclayUniversity Paris SudDepartment of Nuclear Medicine and Endocrine Oncology, Gustave Roussy and Paris SaclayDepartment of Nuclear Medicine and Endocrine Oncology, Gustave Roussy and Paris SaclayDepartment of Gynecologic Surgery, Gustave Roussy and Paris SaclayDepartment of Gynecologic Surgery, Gustave Roussy and Paris SaclayDepartment of Pathology, Gustave Roussy and Paris SaclayDepartment of Medical Oncology, Gustave Roussy and Paris Saclay, 114 Rue Edouard VaillantDepartment of Medical Oncology, Gustave Roussy and Paris Saclay, 114 Rue Edouard VaillantDepartment of Gynecologic Surgery, Gustave Roussy and Paris SaclayDepartment of Nuclear Medicine and Endocrine Oncology, Gustave Roussy and Paris SaclayAbstract Background The 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. Methods A 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. Results Patients 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). Conclusions In 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.https://doi.org/10.1186/s12885-021-07821-9LACCCervical cancerPET/CTTOFPara-aortic lymph nodeFDG |
| spellingShingle | Sebastien Gouy Veronika Seebacher Cyrus Chargari Marie Terroir Serena Grimaldi Anna Ilenko Amandine Maulard Catherine Genestie Alexandra Leary Patricia Pautier Philippe Morice Désirée Deandreis 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 LACC Cervical cancer PET/CT TOF Para-aortic lymph node FDG |
| title | False negative rate at 18F-FDG PET/CT in para-aortic lymphnode involvement in patients with locally advanced cervical cancer: impact of PET technology |
| title_full | False negative rate at 18F-FDG PET/CT in para-aortic lymphnode involvement in patients with locally advanced cervical cancer: impact of PET technology |
| title_fullStr | False negative rate at 18F-FDG PET/CT in para-aortic lymphnode involvement in patients with locally advanced cervical cancer: impact of PET technology |
| title_full_unstemmed | False negative rate at 18F-FDG PET/CT in para-aortic lymphnode involvement in patients with locally advanced cervical cancer: impact of PET technology |
| title_short | False negative rate at 18F-FDG PET/CT in para-aortic lymphnode involvement in patients with locally advanced cervical cancer: impact of PET technology |
| title_sort | false negative rate at 18f fdg pet ct in para aortic lymphnode involvement in patients with locally advanced cervical cancer impact of pet technology |
| topic | LACC Cervical cancer PET/CT TOF Para-aortic lymph node FDG |
| url | https://doi.org/10.1186/s12885-021-07821-9 |
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