Staging of High-Risk Endometrial Cancer With PET/CT and Sentinel Lymph Node Mapping

Signorelli, Mauro; Crivellaro, Cinzia; Buda, Alessandro; Guerra, Luca; Fruscio, Robert; Elisei, Federica; Dolci, Carlotta; Cuzzocrea, Marco; Milani, Rodolfo; Messa, Cristina

doi:10.1097/rlu.0000000000000852

Cited by 63 publications

(37 citation statements)

References 37 publications

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“…Signorelli et al 36 36 In a recent meta-analysis by Bollineni et al, 37 the diagnostic value of PET/CT in the detection of lymph node metastasis in EC was found to be excellent when compared with our results. In our study, PET/CT alone had a very low sensitivity and PPV.…”

Section: Discussionsupporting

confidence: 62%

The Combination of Preoperative Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography and Sentinel Lymph Node Mapping in the Surgical Management of Endometrioid Endometrial Cancer

Beşe¹,

Sal

Demirkıran

et al. 2016

Int J Gynecol Cancer

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Section: Discussionsupporting

confidence: 62%

The Combination of Preoperative Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography and Sentinel Lymph Node Mapping in the Surgical Management of Endometrioid Endometrial Cancer

Beşe¹,

Sal

Demirkıran

et al. 2016

Int J Gynecol Cancer

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“…Obesity and many other morbidities make surgery difficult, and paraaortic assessment may be ignored due to the low probability of isolated metastasis. Most of the isolated paraaortic metastases were diagnosed in high risk cases, and preoperative imaging for these cases can decrease misdiagnosis of isolated paraaortic metastasis 19. Another possible suggestion is to look for upper SLNs, especially in the presacral area, in cases where pelvic mapping has failed 20…”

Section: Discussionmentioning

confidence: 99%

Sentinel lymph node biopsy in early stage endometrial cancer: a Turkish gynecologic oncology group study (TRSGO-SLN-001)

Taşkın

Altın

Vatansever

et al. 2019

Int J Gynecol Cancer

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ObjectiveThe aim of this multicenter study was to evaluate the feasibility of sentinel lymph node (SLN) mapping in clinically uterine confined endometrial cancer.MethodsPatients who underwent primary surgery for endometrial cancer with an SLN algorithm were reviewed. Indocyanine green or blue dye was used as a tracer. SLNs and/or suspicious lymph nodes were resected. Side specific lymphadenectomy was performed when mapping was unsuccessful. SLNs were ultrastaged on final pathology.Results357 eligible patients were analyzed. Median age was 59 years. Median number of resected SLNs was 2 (range 1–12) per patient. Minimal invasive and open surgeries were performed in 264 (73.9%) and 93 (26.1%) patients, respectively. Indocyanine green was used in 231 (64.7%) and blue dye in 126 (35.3%) patients. The dyes were injected into the cervix in 355 (99.4%) patients. The overall and bilateral SLN detection rates were 91.9% and 71.4%, respectively. The mapping rates using indocyanine green or blue dye were comparable (P=0.526). There were 43 (12%) patients with lymphatic metastasis. The SLN algorithm was not able to detect 3 of 43 patients who had isolated paraaortic metastasis. After SLN biopsy, complete pelvic lymphadenectomy was performed in 286 (80.1%) patients. Sensitivity and negative predictive value were both 100% for the detection of pelvic lymph node metastases. In addition, 117 (32.8%) patients underwent completion paraaortic lymphadenectomy after SLN biopsy. In these patients, sensitivity for detecting metastases to pelvic and/or paraaortic lymph nodes was 90.3% with a negative predictive value of 96.6%. The risk of non-SLN involvement in patients with macrometastatic SLNs, micrometastatic SLNs, and isolated tumor cells in SLNs were 61.2%, 14.3% and 0%, respectively.ConclusionsSLN biopsy had good accuracy in detecting lymphatic metastasis. However, one-third of cases with metastatic SLNs also had non-SLN involvement and this risk increased to two-thirds of cases with macrometastatic SLNs. The effect of leaving these nodes in situ on survival should be evaluated in further studies.

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“…1 18F-FDG PET/CT scan has been used as a post-treatment surveillance imaging tool for gynecologic and breast cancer to detect recurrence due to high sensitivity, specificity, and accuracy. 4,7 Bollineni et al demonstrated the high diagnostic performance of 18F-FDG PET/CT not only in identifying lymph node metastasis preoperatively but also in detecting recurrence after endometrial cancer surgery with 95% sensitivity and 91% specificity with an overall diagnostic accuracy of 93%. 2 A systematic review and meta-analysis on the accuracy of 18F-FDG PET imaging on post-treatment monitoring of 541 endometrial cancer patients were reported to have 95.8% sensitivity and 92.5% specificity.…”

Section: Discussionmentioning

confidence: 99%

False-positive Positron Emission Tracing/Computed Tomography Secondary to Suture Granuloma Formation in Early-stage Endometrial Cancer

Magno¹,

Alas²,

Sung³

2019

Journal of South Asian Federation of Obstetrics and Gynaecology

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Suture granuloma formation can cause abnormal radiotracer uptake of 2-deoxy-2-[18F] fluoro-D glucose (FDG) in positron emission tracing/computed tomography (PET/CT) scan. It can be formed secondary to usage of silk suture during surgery as part of delayed host inflammatory reaction to a foreign body.Here, we report a case of a 61-year-old woman diagnosed with endometrial cancer who underwent tumor debulking surgery secondary to abnormal radiotracer uptake in PET/CT suspected as tumor recurrence which on histology revealed suture granuloma.

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Staging of High-Risk Endometrial Cancer With PET/CT and Sentinel Lymph Node Mapping

Cited by 63 publications

References 37 publications

The Combination of Preoperative Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography and Sentinel Lymph Node Mapping in the Surgical Management of Endometrioid Endometrial Cancer

The Combination of Preoperative Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography and Sentinel Lymph Node Mapping in the Surgical Management of Endometrioid Endometrial Cancer

Sentinel lymph node biopsy in early stage endometrial cancer: a Turkish gynecologic oncology group study (TRSGO-SLN-001)

False-positive Positron Emission Tracing/Computed Tomography Secondary to Suture Granuloma Formation in Early-stage Endometrial Cancer

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