Mirror-image lymph node in FDG PET/CT and SPECT/CT for sentinel node detection.
We report a case of a patient with presumed stage IB1 squamous cell carcinoma of the cervix in which FDG PET/CT scan revealed 1 hypermetabolic left iliac node suggestive to be malignant. Lymphoscintigraphy and SPECT/CT studies previous to sentinel node (SLN) biopsy revealed unilateral drainage in the right pelvis. Intraoperative pathological assessment of the SLN showed no tumoral involvement, and the hypermetabolic node revealed macrometastasis. Tumor node invasion can lead to a lymphatic blockage and become false-negative for SLN technique. Although FDG PET/CT has lower sensitivity than surgical staging, this case shows its value as a preoperative imaging technique.
From the Departments of *Nuclear Medicine, and †Gynecology and Obstetrics, Hospital Clinic de Barcelona, Barcelona, Spain.
Beatriz
B
Domenech
Pilar
P
Paredes
Sebastià
S
Rubí
Jaume
J
Pahisa
Sergi
S
Vidal-Sicart
Francesca
F
Pons
D000328:Adult; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D021701:Sentinel Lymph Node Biopsy; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
D019788:Fluorodeoxyglucose F18