Detection of inguinal lymph node involvement in penile squamous cell carcinoma by 18F-fluorodeoxyglucose PET/CT: a prospective single-center study.
BACKGROUND
The extent of lymph node involvement is the most relevant prognostic factor in patients with penile cancer.


OBJECTIVE
To prospectively analyze the diagnostic accuracy of 18F-FDG-PET/CT-scan in the assessment of inguinal lymph node involvement in patients with invasive penile carcinoma.


METHODS
Thirty-five patients with invasive penile carcinoma were staged prospectively by 18F-FDG-PET/CT-scan, and blindly evaluated by 2 nuclear medicine physicians. In total, lymph node involvement was assessed in 70 inguinal groins. Reference standard was either histology or clinical follow-up with a minimum of 31 months (mean: 48.4 months; range: 31-68 months).


RESULTS
18-FDG-PET/CT showed a sensitivity of 88.2% and a specificity of 98.1%. Positive predictive value (PPV) was 93.8%, while negative predictive value (NPV) was 96.3%. In two groins, metastasis of 5 and 7 mm were missed by PET/CT scan.


CONCLUSIONS
18F-FDG-PET/CT is a promising staging tool in assessing the inguinal lymph node involvement of patients with penile carcinoma. Integration of PET/CT scanning into preoperative staging algorithms may avoid surgical staging in selected patients.
Schlenker
Boris
B
Department of Urology, University Hospital Grosshadern, Ludwig-Maximilians University, Munich, Germany. boris.schlenker@med.uni-muenchen.de
Scher
Bernhard
B
Tiling
Reinhold
R
Siegert
Sabine
S
Hungerhuber
Edwin
E
Gratzke
Christian
C
Tilki
Derya
D
Reich
Oliver
O
Schneede
Peter
P
Bartenstein
Peter
P
Stief
Christian G
CG
Seitz
Michael
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000473:pathology; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007264:Inguinal Canal / Q000000981:diagnostic imaging / Q000473:pathology; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D009367:Neoplasm Staging / Q000379:methods*; D010412:Penile Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D011868:Radioisotopes; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
D011868:Radioisotopes; D019788:Fluorodeoxyglucose F18