RT Journal Article SR Electronic T1 Isolated Mediastinal Lymph Node False Positivity of [18F]-Fluorodeoxyglucose–Positron Emission Tomography/Computed Tomography in Patients With Cervical Cancer JF International Journal of Gynecologic Cancer JO Int J Gynecol Cancer FD BMJ Publishing Group Ltd SP 337 OP 342 DO 10.1097/IGC.0b013e31827e00cc VO 23 IS 2 A1 Onal, Cem A1 Oymak, Ezgi A1 Findikcioglu, Alper A1 Reyhan, Mehmet YR 2013 UL http://ijgc.bmj.com/content/23/2/337.abstract AB Objective This study aimed to evaluate the degree of mediastinal involvement in patients with cervical cancer with isolated mediastinal [18F]-fluorodeoxyglucose–positron emission tomography (FDG-PET) positivity as verified by histopathologic examination.Methods Two hundred twenty-eight patients with newly diagnosed cervical cancer and who underwent FDG-PET imaging were analyzed. Twenty-nine patients (17%) had disseminated disease detected with PET/computed tomography (CT). Only 10 patients (4%) had increased FDG uptake in mediastinal lymph nodes alone. Of the 10 patients with mediastinal disease, 2 refused surgical mediastinal lymph node biopsy and did not receive any treatment. Patients with suspected paratracheal or subcarinal lymph node metastasis detected on PET/CT underwent mediastinoscopy, and those with hilar metastasis had video-assisted mediastinal lymphadenectomy. Treatment was delivered according to final staging based on histopathologic confirmation of mediastinal lymph node involvement.Results The mean (SD) maximum standardized uptake values for primary cervical tumor and mediastinal lymph nodes were 19.7 (10.3) and 7.5 (1.6), respectively. Of 8 patients who underwent mediastinal lymph node confirmation, 6 (75%) were tumor free, demonstrating granulomatous changes, and were treated curatively. No patients had residual or recurrent disease at the primary site, and all but 1 were alive without disease. Two patients with confirmed mediastinal lymph node metastasis were treated palliatively and died between 9 and 11 months after diagnosis.Conclusions Positron emission tomography/CT is an important tool for lymphatic staging and evaluation of distant metastases in cervical cancer. However, PET/CT should be interpreted cautiously for isolated mediastinal involvement; surgical evaluation is required for accurate staging and appropriate treatment decisions to achieve better outcomes.