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Whole-body [18F]fluoro-2-deoxyglucose positron emission tomography scan staging prior to planned radical hysterectomy and pelvic lymphadenectomy
  1. J. B. UNGER*,
  2. J. J. IVY*,
  3. M. R. RAMASWAMY,
  4. A. CHARRIER* and
  5. P. CONNOR*
  1. *Division of Gynecologic Pelvic Surgery, Department of Obstetrics and Gynecology
  2. PET Imaging Center of the Biomedical Research Foundation of Northwest Louisiana, Louisiana State University Health Sciences Center, Shreveport, Louisiana
  1. Address correspondence and reprint requests to: James B. Unger, MD, Division of Pelvic Surgery, Department of Obstetrics and Gynecology, Louisiana State University Health Sciences Center, P.O. Box 33932, 1501 Kings Highway, Shreveport, LA 71130-3932, USA. Email: junger{at}lsuhsc.edu

Abstract

The aim of the study was to determine the effectiveness of whole-body [18F]fluoro-2-deoxyglucose positron emission tomography (FDG PET) imaging in properly selecting candidates for radical hysterectomy who are at low risk for subsequent chemoradiation. Retrospective study of 14 women undergoing planned radical hysterectomy and pelvic lymphadenectomy with clinically localized cervical cancer and either negative or inconclusive metastatic nodal disease by PET scan was performed. Pelvic lymph nodes were clearly negative by FDG PET scan in 12 of the 14 women. Two women had focal FDG uptake suspicious, although not definitive, for nodal metastasis, and pelvic nodes were positive at surgery in both. Computed tomography (CT) scan failed to detect nodal disease in either woman. Neither PET nor CT was effective at detecting parametrial disease, and both also failed to detect the primary tumor in some cases. Women with FDG PET scans that are clearly negative for nodal disease are good candidates for radical hysterectomy and are at low risk for subsequent chemoradiation.

  • chemoradiation
  • FDG PET
  • radical hysterectomy

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