Journal article
Utility of F-18-FDG PET/CT in identifying penile squamous cell carcinoma metastatic lymph nodes
Urologic oncology, Vol.30(5), pp.723-726
09/01/2012
DOI: 10.1016/j.urolonc.2010.09.015
PMID: 21396850
Abstract
Objectives: Due to the significant potential morbidity of inguinal and pelvic lymphadenectomy, the search for an imaging modality that can accurately identify penile squamous cell carcinoma (SCCA) lymphatic metastases continues. Initial F-18-FDG PET/CT studies have reported 80% sensitivity and 100% specificity in the detection of inguinal and obturator lymph node metastasis. We review a single institutional experience of F-18-FDG PET/CT imaging of SCCA of the penis to assess for accuracy and potential impact on clinical management.
Methods: Three patients diagnosed with penile SCCA at a single institution underwent staging F-18-FDG PET/CT and went on to subsequent inguinal lymph node dissection. The F-18-FDG PET machine was a Philips Gemini Time-of-Flight PET with LYSO crystals with 4.7 mm spatial resolution. The CT was a 16-slice helical CT with 5 mm slice widths. F-18-FDG PET/CT findings were compared with the histologic findings of these procedures. Decision to proceed with lymphadenectomy was based on clinical judgment of a single urologist and all fused F-18-FDG PET/CT imaging was assessed by a single experienced radiologist.
Results: No patient received chemotherapy or radiation before the F-18-FDG PET/CT or surgery. The first patient was obese (BMI > 30), clinically node negative, and the F-18-FDG PET/CT showed inflammation. Histologic examination showed a positive 2 cm right inguinal metastatic node. The second patient's F-18-FDG PET/CT showed a suspicious 1 cm left inguinal node. Histologically, the suspicious lymph node was positive for SCCA as was a second positive 2 cm lymph node not identified on preoperative F-18-FDG PET/CT. Clinical exam of this patient was negative. The third patient was F-18-FDG PET/CT and clinically negative but subsequently developed a palpable lymph node approximately 1 month later, which was suspicious on repeat F-18-FDG PET/CT and positive for SCCA on histological examination.
Conclusions: F-18-FDG PET/CT has shown initial promise in the staging of penile SCCA. However, our review shows that false negative studies occur at alarmingly high rates, and F-18-FDG PET/CT is poor in detection of micro-metastasis. Thus, close follow-up in these patients is imperative. (c) 2012 Elsevier Inc. All rights reserved.
Details
- Title: Subtitle
- Utility of F-18-FDG PET/CT in identifying penile squamous cell carcinoma metastatic lymph nodes
- Creators
- Henry M. Rosevear - University of IowaHadyn Williams - Augusta UniversityMatthew Collins - Augusta UniversityAndrew J. Lightfoot - University of IowaTeresa Coleman - Augusta UniversityJames A. Brown - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Urologic oncology, Vol.30(5), pp.723-726
- Publisher
- Elsevier
- DOI
- 10.1016/j.urolonc.2010.09.015
- PMID
- 21396850
- ISSN
- 1078-1439
- eISSN
- 1873-2496
- Number of pages
- 4
- Language
- English
- Date published
- 09/01/2012
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Urology
- Record Identifier
- 9984320857602771
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