Staging of primary cervical cancers: the role of nuclear medicine.
In nuclear medicine, [18F]-fluorodeoxyglucose positron emission tomography (18FDG PET) and lymphatic mapping and sentinel lymphadenectomy (LM/SL) may significantly improve the staging of primary cervical cancers. Indeed, the disease progresses in a 'level by level' fashion to regional nodes through the lymphatic channels, and also to extra-nodal sites via the hematogenous stream. Additionally, the sub-optimal efficacy of routine radiological protocols, while new combined therapies are proving to be more efficient, stresses the need for alternative staging procedures. Current data suggest that LM/SL accurately reflects the regional lymph node status in early stage cervical cancers, and thus could avoid unnecessary complete lymphadenectomies. Also, whole body 18FDG PET may provide valuable insights on extra-pelvic and distant tumor spreading, with a significant impact on treatment choices. If these promising results are confirmed on large controlled trials, LM/SL and 18FDG PET imaging could be incorporated in the routine staging work-up of primary cervical cancers.
Belhocine
Tarik
T
Division of Nuclear Medicine, University Hospital of Liège, Sart Tilman-Bât. 35, 4000, Liège, Belgium. tarik.bel@swing.be
Kridelka
Frédéric
F
Thille
Alain
A
De Barsy
Caroline
C
Foidart-Willems
Jacqueline
J
Hustinx
Roland
R
Rigo
Pierre
P
D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging; D009367:Neoplasm Staging / Q000379:methods; D019275:Radiopharmaceuticals; D021701:Sentinel Lymph Node Biopsy; D014055:Tomography, Emission-Computed / Q000379:methods; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18