Detection of nodal metastases by 18F-FDG PET/CT in apparent early stage ovarian cancer: A prospective study

Signorelli, Mauro; Guerra, Luca; Pirovano, Cecilia; Crivellaro, Cinzia; Fruscio, Robert; Buda, Alessandro; Cuzzucrea, Marco; Elisei, Federica; Ceppi, Lorenzo; Messa, Cristina

doi:10.1016/j.ygyno.2013.08.022

Cited by 68 publications

(36 citation statements)

References 38 publications

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“…In gynecologic malignancies, cancer spreads mostly through the lymphatic vessels, which has a prognostic value [8]. In EOC, the rate of lymph node metastasis is lower in early-stage tumors [9].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Factors Affecting Lymph Node Metastasis in Clinical Stage I-II Epithelial Ovarian Cancer

et al. 2018

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Background: Systematic lymphadenectomy is useful for accurate staging of early-stage ovarian cancer and has obvious prognostic value. Accurate staging may prevent unnecessary postoperative chemotherapy. The aim of this study was to evaluate the rate of lymph node involvement and factors affecting it in clinically early-stage epithelial ovarian cancer (EOC; stages I, II). Patients and Methods: The study included 163 patients who underwent surgery at our hospital between January 2004 and April 2017 and who were diagnosed with early-stage EOC based on preoperative and intraoperative examination. Patient data were retrospectively analyzed. The rate of lymph node involvement and factors affecting it were analyzed. Results: Of 163 patients, 21 (12.9%) had lymph node metastasis, whereas 16 (16.3%) of 98 patients who underwent comprehensive lymphadenectomy had lymph node metastasis. According to the univariate results for patients undergoing any type of lymphadenectomy, the rate of positive lymph nodes was significantly higher (37.1%) in those with bilateral ovarian involvement (p < 0.001). The rate was significantly higher in patients with positive intraabdominal fluid cytology (25.9%; p < 0.001), serous histology (20.5%; p = 0.02), and grade 3 disease (33.3%; p < 0.001). In multivariate logistic regression analysis, the rate was significantly higher in patients with bilateral adnexal involvement (p = 0.012). The risk of positive lymph nodes was significantly higher in patients with grade 3 disease (p = 0.016). Conclusion: Comprehensive lymphadenectomy increases the detection rate for metastatic lymph nodes in patients with clinically early-stage EOC. The rate of lymph node involvement is significantly higher in grade 3 tumors, serous cytology, bilateral adnexal involvement, and positive intraabdominal fluid cytology.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Factors Affecting Lymph Node Metastasis in Clinical Stage I-II Epithelial Ovarian Cancer

et al. 2018

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“…Of these, two studies used ce PET/CT for analysis[1223] and the rest of the studies used ld PET/CT for analysis. [242526272829]…”

Section: Evidence Synthesismentioning

confidence: 99%

Systematic review on the accuracy of positron emission tomography/computed tomography and positron emission tomography/magnetic resonance imaging in the management of ovarian cancer: Is functional information really needed?

et al. 2017

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Ovarian cancer (OC) often presents at an advanced stage with frequent relapses despite optimal treatment; thus, accurate staging and restaging are required for improving treatment outcomes and prognostication. Conventionally, staging of OC is performed using contrast-enhanced computed tomography (CT). Nevertheless, recent advances in the field of hybrid imaging have made positron emission tomography/CT (PET/CT) and PET/magnetic resonance imaging (PET/MRI) as emerging potential noninvasive imaging tools for improved management of OC. Several studies have championed the role of PET/CT for the detection of recurrence and prognostication of OC. We provide a systematic review and meta-analysis of the latest publications regarding the role of molecular imaging in the management of OC. We retrieved 57 original research articles with one article having overlap in both diagnosis and staging; 10 articles (734 patients) regarding the role of PET/CT in diagnosis of OC; 12 articles (604 patients) regarding staging of OC; 22 studies (1429 patients) for detection of recurrence; and 13 articles for prognostication and assessment of treatment response. We calculated pooled sensitivity and specificity of PET/CT performance in various aspects of imaging of OC. We also discussed the emerging role of PET/MRI in the management of OC. We aim to give the readers and objective overview on the role of molecular imaging in the management of OC.

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“…79,85,86 For the detection of retroperitoneal lymph node metastasis, 18 F-FDG PET/CT had a greater accuracy of 95.6% compared with CT and MRI, while no significant difference was evident between CT and MRI. [87][88][89] For the detection of peritoneal disease, multidetector-row CT, MRI, and 18 F-FDG PET/CT had a sensitivity of 96%, 98%, and 95% and specificity of 92%, 84%, and 96%, respectively, showing no significant difference. 90,91 Whole-body MRI with DWI may improve the accuracy for detecting peritoneal disease.…”

Section: Ovarian Cancermentioning

confidence: 96%

Diagnostic imaging using positron emission tomography for gynecological malignancy

Tsuyoshi

Yoshida

2017

J of Obstet and Gynaecol

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Imaging has played a pivotal role in the management of gynecological malignancy. Positron emission tomography (PET), particularly 18 F-fluorodeoxyglucose ( 18 F-FDG) PET to reflect cellular glycolytic metabolism, is being increasingly used and has proven superior to conventional imaging including ultrasonography, computed tomography (CT), and magnetic resonance imaging. Studies of and evidence for the utility of 18 F-FDG PET/CT for the detection of local or metastatic disease, treatment planning, response assessment, restaging of recurrent disease, and prognostic assessment are growing. We review the latest evidence for and limitations of 18 F-FDG PET/CT in the diagnosis of gynecological malignancy. Moreover, we also describe the benefits of and evidence for other tracers.

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Detection of nodal metastases by 18F-FDG PET/CT in apparent early stage ovarian cancer: A prospective study

Cited by 68 publications

References 38 publications

Evaluation of Factors Affecting Lymph Node Metastasis in Clinical Stage I-II Epithelial Ovarian Cancer

Evaluation of Factors Affecting Lymph Node Metastasis in Clinical Stage I-II Epithelial Ovarian Cancer

Systematic review on the accuracy of positron emission tomography/computed tomography and positron emission tomography/magnetic resonance imaging in the management of ovarian cancer: Is functional information really needed?

Diagnostic imaging using positron emission tomography for gynecological malignancy

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