title: Detection of inguinal lymph node involvement in penile squamous cell carcinoma by 18F-fluorodeoxyglucose PET/CT: a prospective single-center study.
abstract: 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.
authors.affiliation: Department of Urology, University Hospital Grosshadern, Ludwig-Maximilians University, Munich, Germany. boris.schlenker@med.uni-muenchen.de
authors.forename: Boris
authors.initials: B
authors.lastname: Schlenker
authors.forename: Bernhard
authors.initials: B
authors.lastname: Scher
authors.forename: Reinhold
authors.initials: R
authors.lastname: Tiling
authors.forename: Sabine
authors.initials: S
authors.lastname: Siegert
authors.forename: Edwin
authors.initials: E
authors.lastname: Hungerhuber
authors.forename: Christian
authors.initials: C
authors.lastname: Gratzke
authors.forename: Derya
authors.initials: D
authors.lastname: Tilki
authors.forename: Oliver
authors.initials: O
authors.lastname: Reich
authors.forename: Peter
authors.initials: P
authors.lastname: Schneede
authors.forename: Peter
authors.initials: P
authors.lastname: Bartenstein
authors.forename: Christian G
authors.initials: CG
authors.lastname: Stief
authors.forename: Michael
authors.initials: M
authors.lastname: Seitz
mesh_terms: 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
chemical_list: D011868:Radioisotopes; D019788:Fluorodeoxyglucose F18