title: Computed tomography, magnetic resonance imaging and FDG positron emission tomography in the management of vulvar malignancies.
abstract: OBJECTIVE
  To prospectively evaluate the value of CT or MRI (CT/MRI) and PET in the management of vulvar malignancies.
  
  
  METHODS
  Abdominal and pelvic CT/MRI and whole-body (18) F-FDG (fluorodeoxyglucose) PET or PET/CT (collectively designated PET hereafter) were performed. Lesion status was determined by the pathological findings or clinical follow-up. The diagnostic efficacy was evaluated by receiver operating characteristic (ROC) curve analysis. The clinical impact of PET was determined on a per scan basis.
  
  
  RESULTS
  Twenty-three patients were enrolled, and 38 PET examinations were performed. CT/MRI and PET studies were used for primary staging (n = 17), monitoring the response (n = 7) and restaging after recurrence (n = 14). In primary staging, there was no significant difference between CT/MRI and PET in detecting metastatic inguinal lymph nodes (ILN). CT/MRI was significantly more efficacious than PET in detecting pelvic lymph node (PLN) or distant metastasis (p = 0.007 by ROC per patient basis). PET findings resulted in two positive impacts and one negative impact for both primary staging and restaging.
  
  
  CONCLUSIONS
  False-positive PLN or distant metastasis PET findings are not uncommon, and hence should be interpreted with caution. PET can be supportive when metastatic ILN/PLN or distant metastasis is suspected on CT/MRI.
  
  
  CONCLUSIONS
  • False-positive metastatic PLN or distant metastasis PET findings are not uncommon. • CT/MRI has value in the management of vulvar malignancies. • PET can be supportive when metastasis is suspected by CT/MRI.
authors.affiliation: Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Gigin
authors.initials: G
authors.lastname: Lin
authors.forename: Chao-Yu
authors.initials: CY
authors.lastname: Chen
authors.forename: Feng-Yuan
authors.initials: FY
authors.lastname: Liu
authors.forename: Lan-Yan
authors.initials: LY
authors.lastname: Yang
authors.forename: Huei-Jean
authors.initials: HJ
authors.lastname: Huang
authors.forename: Yi-Ting
authors.initials: YT
authors.lastname: Huang
authors.forename: Shih-Ming
authors.initials: SM
authors.lastname: Jung
authors.forename: Hung-Hsueh
authors.initials: HH
authors.lastname: Chou
authors.forename: Chyong-Huey
authors.initials: CH
authors.lastname: Lai
authors.forename: Koon-Kwan
authors.initials: KK
authors.lastname: Ng
mesh_terms: D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography / Q000379:methods*; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014844:Vulva / Q000000981:diagnostic imaging / Q000473:pathology; D014846:Vulvar Neoplasms / Q000175:diagnosis*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18