Anzeige
Erschienen in:
01.05.2015 | Oncology
Computed tomography, magnetic resonance imaging and FDG positron emission tomography in the management of vulvar malignancies
Erschienen in: European Radiology | Ausgabe 5/2015
Einloggen, um Zugang zu erhaltenAbstract
Objectives
To prospectively evaluate the value of CT or MRI (CT/MRI) and PET in the management of vulvar malignancies.
Methods
Abdominal and pelvic CT/MRI and whole-body 18 F-FDG (fluorodeoxyglucose) PET or PET/CT (collectively designated PET hereafter) were performed. Lesion status was determined by the pathological findings or clinical follow-up. The diagnostic efficacy was evaluated by receiver operating characteristic (ROC) curve analysis. The clinical impact of PET was determined on a per scan basis.
Results
Twenty-three patients were enrolled, and 38 PET examinations were performed. CT/MRI and PET studies were used for primary staging (n = 17), monitoring the response (n = 7) and restaging after recurrence (n = 14). In primary staging, there was no significant difference between CT/MRI and PET in detecting metastatic inguinal lymph nodes (ILN). CT/MRI was significantly more efficacious than PET in detecting pelvic lymph node (PLN) or distant metastasis (p = 0.007 by ROC per patient basis). PET findings resulted in two positive impacts and one negative impact for both primary staging and restaging.
Conclusions
False-positive PLN or distant metastasis PET findings are not uncommon, and hence should be interpreted with caution. PET can be supportive when metastatic ILN/PLN or distant metastasis is suspected on CT/MRI.
Key Points
• False-positive metastatic PLN or distant metastasis PET findings are not uncommon.
• CT/MRI has value in the management of vulvar malignancies.
• PET can be supportive when metastasis is suspected by CT/MRI.