HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ma, S.-Y. Articles by Yen, T.-C. Search for Related Content PubMed PubMed Citation Articles by Ma, S.-Y. Articles by Yen, T.-C.

Delayed ¹⁸F-FDG PET for Detection of Paraaortic Lymph Node Metastases in Cervical Cancer Patients

¹ Department of Nuclear Medicine, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
² Biostatistics Consulting Center, Department of Public Health, Chang Gung University, Taoyuan, Taiwan
³ Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
⁴ Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
⁵ Department of Radiology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
⁶ Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
⁷ Institute of Nuclear Energy Research, Taoyuan, Taiwan

This prospective study investigated the usefulness of dual-phase ¹⁸F-FDG PET scans (40 min and 3 h) in detecting paraaortic lymph node (PALN) metastasis for cervical cancer. Methods: One hundred four consecutive cervical cancer patients (International Federation of Gynecology and Obstetrics staging Ib–IVb, recurrent or persistent tumors) were included. All patients received a whole-body ¹⁸F-FDG PET scan at 40 min and an additional scan from the T11 level to the inguinal region at 3 h after injection of 370 MBq ¹⁸F-FDG. The maximum standardized uptake value (SUV) and retention index (RI [%], obtained by subtracting the normalized SUV value obtained at 40 min from that at 3 h) of the lesions were determined. Results: In all, 38 of the 104 patients were confirmed to have PALN metastases. For 31 patients (81.6%) with 13 upper (L1–L2 level) and 30 lower (L3–L4 level) PALNs, these metastases were detected with the 40-min scan. In addition, for 7 patients (18.4%) with 7 lower PALNs, metastases were found with the 3-h scan (RI = 12.6%). Two patients (3.0%) had 2 false-positive lesions initially (40 min) but were classified as benign with the 3-h scan. The sensitivity, specificity, and accuracy of ¹⁸F-FDG PET scans at 40 min were 81.6%, 97.0%, and 91.3%, respectively. These quantities were all 100% when both the 40-min and 3-h scans were taken together. Eight patients (21.1%) had their treatment planning changed. We divided the 38 patients into 2 subgroups. Subgroup A included those with either only upper or only lower PALN metastases, and subgroup B included those with both upper and lower PALN metastases. In subgroup A, the SUV values were greater in the upper than in the lower PALNs in both the 40-min and 3-h images (P = 0.077). In subgroup B, there was no significant difference of SUV values between upper and lower PALNs in the 40-min (P = 0.433) and 3-h (P = 0.937) images. Conclusion: Our results showed that an additional 3-h scan is helpful for PALN detection of cervical cancer patients. A delayed image (3 h) is especially useful for lower PALN metastases.

Key Words: delayed ¹⁸F-FDG PET • paraaortic lymph nodes • cervical cancer

This article has been cited by other articles:

				T. Nakagawa, M. Yamada, and Y. Suzuki 18F-FDG Uptake in Reactive Neck Lymph Nodes of Oral Cancer: Relationship to Lymphoid Follicles J. Nucl. Med., July 1, 2008; 49(7): 1053 - 1059. [Abstract] [Full Text] [PDF]

				A. Mavi, M. Urhan, J. Q. Yu, H. Zhuang, M. Houseni, T. F. Cermik, D. Thiruvenkatasamy, B. Czerniecki, M. Schnall, and A. Alavi Dual Time Point 18F-FDG PET Imaging Detects Breast Cancer with High Sensitivity and Correlates Well with Histologic Subtypes J. Nucl. Med., September 1, 2006; 47(9): 1440 - 1446. [Abstract] [Full Text] [PDF]

				N. Pandit-Taskar Oncologic Imaging in Gynecologic Malignancies J. Nucl. Med., November 1, 2005; 46(11): 1842 - 1850. [Abstract] [Full Text] [PDF]

				T.-C. Yen, L.-C. See, T.-C. Chang, K.-G. Huang, K.-K. Ng, S. G. Tang, Y.-C. Chang, S. Hsueh, C.-S. Tsai, J.-H. Hong, et al. Defining the Priority of Using 18F-FDG PET for Recurrent Cervical Cancer J. Nucl. Med., October 1, 2004; 45(10): 1632 - 1639. [Abstract] [Full Text] [PDF]

				T.-C. Yen, L.-C. See, C.-H. Lai, C. W. Yah-Huei, K.-K. Ng, S.-Y. Ma, W.-J. Lin, J.-T. Chen, W.-J. Chen, C.-R. Lai, et al. 18F-FDG Uptake in Squamous Cell Carcinoma of the Cervix Is Correlated with Glucose Transporter 1 Expression J. Nucl. Med., January 1, 2004; 45(1): 22 - 29. [Abstract] [Full Text] [PDF]