title: Fluorodeoxyglucose positron emission tomography-computed tomography in evaluation of pelvic and para-aortic nodal involvement in early stage and operable cervical cancer: Comparison with surgicopathological findings.
abstract: BACKGROUND
  Nodal metastases in cervical cancer have prognostic implications. Imaging is used as an adjunct to clinical staging for evaluation of nodal metastases. Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) has an advantage of superior resolution of its CT component and detecting nodal disease based on increased glycolytic activity rather than node size. But there are limited studies describing its limitations in early stage cervical cancers.
  
  
  OBJECTIVE
  We have done meta-analysis with an objective to evaluate the efficacy of FDG PET/CT and its current clinical role in early stage and operable cervical cancer.
  
  
  METHODS
  Studies in which FDG PET/CT was performed before surgery in patients with early stage cervical cancers were included for analysis. PET findings were confirmed with histopathological diagnosis rather than clinical follow-up. FDG PET/CT showed lower sensitivity and clinically unacceptable negative predictive value in detecting nodal metastases in early stage cervical cancer and therefore, can not replace surgicopathological staging. False negative results in presence of microscopic disease and sub-centimeter diseased nodes are still the area of concern for metabolic imaging. However, these studies are single institutional and performed in a small group of patients. There is enough available evidence of clinical utility of FDG PET/CT in locally advanced cervical cancer. But these results can not be extrapolated for early stage disease.
  
  
  CONCLUSIONS
  The current data suggest that FDG PET/CT is suboptimal in nodal staging in early stage cervical cancer.
authors.affiliation: Department of Obstetrics and Gynecology, Nowrosjee Wadia Maternity Hospital, Parel, Mumbai, Maharashtra, India.
authors.forename: Vandana
authors.initials: V
authors.lastname: Bansal
authors.forename: Kaizad
authors.initials: K
authors.lastname: Damania
authors.forename: Anshu Rajnish
authors.initials: AR
authors.lastname: Sharma
keywords: Early stage cervical cancer; fluorodeoxyglucose positron emission tomography–computed tomography; operable carcinoma cervix; preoperative; surgicopathological
references.citation: J Clin Oncol. 2010 Apr 20;28(12):2108-13
references.pmid: 20308664
references.citation: Int J Gynecol Cancer. 2010 Aug;20(6):1041-5
references.pmid: 20683414
references.citation: Gynecol Obstet Invest. 2009;67(1):61-6
references.pmid: 18843187
references.citation: Gynecol Obstet Fertil. 2011 Apr;39(4):193-7
references.pmid: 21429783
references.citation: Gynecol Oncol. 2005 Apr;97(1):183-91
references.pmid: 15790456
references.citation: Indian J Cancer. 2009 Apr-Jun;46(2):155-9
references.pmid: 19346651
references.citation: Eur Radiol. 2009 Jun;19(6):1529-36
references.pmid: 19184037
references.citation: AJR Am J Roentgenol. 2011 May;196(5):1225-33
references.pmid: 21512096
references.citation: J Clin Oncol. 2008 May 20;26(15):2558-61
references.pmid: 18487573
references.citation: Int J Clin Oncol. 2007 Jun;12(3):165-75
references.pmid: 17566838
references.citation: J Natl Compr Canc Netw. 2008 Jan;6(1):37-45
references.pmid: 18267057
references.citation: Radiology. 2006 Jan;238(1):272-9
references.pmid: 16304090
references.citation: Gynecol Oncol. 2011 Nov;123(2):236-40
references.pmid: 21855972
references.citation: Int J Gynaecol Obstet. 2009 May;105(2):107-8
references.pmid: 19342051