Positron emission tomography-computed tomography for inguinal nodes in vulvar cancer

We aimed to determine the sensitivity and specificity of fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) for the spread of disease to inguinal lymph nodes in vulvar cancer. A retrospective review of vulvar cancer patients who underwent both inguinal nodal sampling and dissection as well as FDG PET-CT was performed, with 21 patients meeting criteria. The sensitivity and specificity of the FDG PET-CT imaging was performed using a combination of maximum standardized uptake value (SUV_max), metabolic tumor volume (MTV), and total lesion glycolysis (TLG). Using an SUV_maxcutoff of 4.5 or of two times the average liver uptake, we had a 100% sensitivity and 89% specificity for positive inguinal nodes. MTV and TLG did not add to sensitivity or specificity. We conclude that FDG PET-CT has good sensitivity for inguinal nodal spread in vulvar cancer, and either a quantitative or semiquantitative approach is effective.

Keywords

Fluorodeoxyglucose positron emission tomography-computed tomography - maximum standardized uptake value - metabolic tumor volume - quantitative imaging - total lesion glycolysis - vulvar cancer