title: Staging of primary cervical cancers: the role of nuclear medicine.
abstract: 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.
authors.affiliation: Division of Nuclear Medicine, University Hospital of Liège, Sart Tilman-Bât. 35, 4000, Liège, Belgium. tarik.bel@swing.be
authors.forename: Tarik
authors.initials: T
authors.lastname: Belhocine
authors.forename: Frédéric
authors.initials: F
authors.lastname: Kridelka
authors.forename: Alain
authors.initials: A
authors.lastname: Thille
authors.forename: Caroline
authors.initials: C
authors.lastname: De Barsy
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Foidart-Willems
authors.forename: Roland
authors.initials: R
authors.lastname: Hustinx
authors.forename: Pierre
authors.initials: P
authors.lastname: Rigo
mesh_terms: 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
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18