title: 18 Fluoro-2deoxy-d-glucose-positron emission tomography and locally advanced cervical cancer.
abstract: The aim of this study was to compare 18 fluoro-2deoxy-d-glucose-positron emission tomography (FDG-PET) after chemoradiation to histological findings after lymphadenectomy and radical hysterectomy and thus evaluate if FDG-PET could avoid surgery when negative.
  
  
  METHODS
  : Twenty-one patients with locally advanced cervical cancer treated by chemoradiation, brachytherapy, and adjuvant surgery were prospectively enrolled. 18 Fluoro-2deoxy-d-glucose-PET was realized 5 weeks after concomitant chemoradiation and compared with histology.
  
  
  RESULTS
  : 18 Fluoro-2deoxy-d-glucose-PET assessed residual cervical involvement after chemoradiation with a sensitivity of 27.3%, specificity of 90%, and positive predictive value (PPV) of 75%. The negative predictive value (NPV) and the false-negative rate (FN) were 50%. Among patients with no evidence of disease on FDG-PET but with residual involvement on histology, 75% had residual involvement size under10 mm.For residual pelvic lymph node involvement, the specificity was 100%, NPV was 83.3%, and FN rate was 16.7%.For residual paraaortic lymph node involvement, specificity and sensitivity were 100%, but only 1 patient was concerned. Considering all the lymph node locations, sensitivity was 20%, specificity 100%, PPV 100%, and NPV 90%.Considering all localizations for each patient, control FDG-PET had a 30% sensitivity, 87% specificity, 80% PPV, and 43% NPV. False-negative rate was 43%.
  
  
  CONCLUSIONS
  : The aim of this study was to evaluate if control FDG-PET might avoid surgery for patients with a negative screening. Although FDG-PET is an interesting diagnostic test for residual lymph node involvement evaluation, it seems not accurate enough to be the only element of the surgery's indication. However, our sample size was too small to definitely conclude.
authors.affiliation: Institut PAOLI CALMETTES, Marseille, France.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Motton
authors.forename: Thomas
authors.initials: T
authors.lastname: De Lapparent
authors.forename: Isabelle
authors.initials: I
authors.lastname: Brenot-Rossi
authors.forename: Max
authors.initials: M
authors.lastname: Buttarelli
authors.forename: Maryam
authors.initials: M
authors.lastname: Al Nakib
authors.forename: Jocelyne
authors.initials: J
authors.lastname: Jacquemier
authors.forename: Agnès
authors.initials: A
authors.lastname: Tallet
authors.forename: Gilles
authors.initials: G
authors.lastname: Houvenaeghel
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008875:Middle Aged; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18