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Prospective evaluation of hybrid 18 F‐fluorodeoxyglucose positron emission tomography/computed tomography in staging clinically node‐negative patients with penile carcinoma
Author(s) -
Leijte Joost A.P.,
Graafland Niels M.,
Valdés Olmos Renato A.,
Van Boven Hester H.,
Hoefnagel Cornelis A.,
Horenblas Simon
Publication year - 2009
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2009.08450.x
Subject(s) - medicine , sentinel node , positron emission tomography , occult , radiology , fluorodeoxyglucose , nuclear medicine , metastasis , carcinoma , biopsy , cancer , breast cancer , pathology , alternative medicine
OBJECTIVE To prospectively evaluate the performance of 18 F‐fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F‐FDG PET/CT) to detect occult metastasis in patients with clinically node‐negative (cN0) penile carcinoma, as there is little information on the use of 18 F‐FDG‐PET/CT in penile carcinoma. PATIENTS AND METHODS In 24 patients, scheduled to undergo dynamic sentinel‐node biopsy, hybrid PET/CT was used before surgery to assess the nodal status of the cN0‐groins. Six of the 24 patients were unilaterally cN0. Thus, 42 cN0‐groins were evaluated for occult metastasis using PET/CT. All scans were assessed by two experienced nuclear physicians. The histopathological tumour status of the removed sentinel node was used as the standard of care to evaluate the PET/CT‐results. RESULTS Histopathology was tumour‐positive in five of the 42 (12%) evaluated cN0‐groins, two of which contained only micrometastases (<2 mm). One of the five tumour‐positive cN0‐groins was correctly predicted on the PET/CT‐images. All false‐negative PET/CT scans contained metastasis of ≤10 mm. Of the remaining 37 tumour‐negative groins, 34 were correctly predicted with PET/CT (specificity 92%). CONCLUSION The role of PET/CT in evaluating the groins of patients with cN0 penile cancer appears to be limited, due to its low sensitivity. In this series, only one of the five tumour‐positive groins was identified. Surgical staging methods remain necessary at present.