PT - JOURNAL ARTICLE AU - Minnaar, Carrie AU - Ayeni, Olusegun Akinwale AU - Vangu, Mboyo TI - Ms DP - 2018 May 01 TA - Journal of Nuclear Medicine PG - 396--396 VI - 59 IP - supplement 1 4099 - http://jnm.snmjournals.org/content/59/supplement_1/396.short 4100 - http://jnm.snmjournals.org/content/59/supplement_1/396.full SO - J Nucl Med2018 May 01; 59 AB - 396Purpose: 18F-FDG PET/CT in locally advanced cervical cancer- patterns of nodal disease in Sub-Saharan Africa Objectives: PET/CT is known to have a high diagnostic value in patients with cancer of the cervix. The prognosis of disease often depends on the status of involvement of the lymph nodes. The usual metastatic spread occurs in the pelvis prior to spreading caudo-cranially to the supraclavicular region. The aim of this study is to determine the patterns of nodal disease in a subset of the Sub-Saharan population. Methods: We use 25118F-FDG PET/CT imaging studies from participants of an on-going Phase III randomised clinical trial. In order to investigate the effects of chemoradiotherapy versus thermo-chemoradiotherapy, all participants are required to have pre-treatment PET/CT studies. All participants are in FIGO stage IIb (with distal involvement of the parametrium) to IIIb of disease. The nodal patterns (number of nodes; size; uptake by means of SUV; relationship between nodal size and SUV uptake), were assessed. Comparison of different patterns was done between different anatomical regions that included the pelvis, abdomen, thorax and neck. Frequencies and percentages were calculated. We used Chi2, unpaired t-test, linear regression to measure associations and differences. The study was approved by the local Human Research and Ethics Committee. Results: In total 1298 nodes were visualised, 55% (n=712) of which were seen in participants with associated HIV infection. A significantly higher number of nodes is seen in the pelvis (n=486) as compared to the abdomen (n=172; p=0.000), thorax (n=217; p=0.000) and neck (n=214; p=0.000) regions. Larger lymph nodes are more frequently associated with the pelvis than the abdomen (p=0.000) and the neck (p=0.07). The pelvis is also the region with significantly higher SUVs (p < 0.001) as compared to all the other anatomical regions. A significant association is seen between the lymph node size and the level of SUV uptake in all the regions (p=0.000). There is also a significant association noted between the number of nodes visualised in the neck and the HIV status (p=0.016). No significant difference or association is observed between the SUV and HIV status. Conclusions: This study shows a predominance of lymphadenopathy in the pelvis and this is consistent with the natural path of the disease. PET/CT with 18F-FDG demonstrates that the pelvis harbours higher numbers of larger and more active lymph nodes. Lymph nodes seen in the neck region in patients with locally advanced cervical cancer and associated HIV infection are more likely to be inflammatory in nature. However to accurately differentiate between metastatic disease and inflammatory nature of nodes visualised on PET/CT, one must use tissue diagnosis.