title: The impact of FDG-PET/CT in the management of patients with vulvar and vaginal cancer.
abstract: OBJECTIVE
  To evaluate the changes in prognostic impression and patient management following PET/CT in patients with vulvar and vaginal carcinoma; and to compare PET/CT findings with those of conventional imaging modalities.
  
  
  METHODS
  We summarized prospectively and retrospectively collected data for 50 consecutive patients from our institution that enrolled in the National Oncologic PET Registry and underwent FDG-PET/CT for a suspected or known primary or recurrent vulvar/vaginal cancer.
  
  
  RESULTS
  54/83 (65%) studies included had a diagnosis of vulvar cancer, and the remaining 29/83 (35%), a diagnosis of vaginal cancer. Following FDG-PET/CT, the physician's prognostic impression changed in 51% of cases. A change in patient management, defined as a change to/from a non-interventional strategy (observation or additional imaging), to/from an interventional strategy (biopsy or treatment), was documented in 36% of studies. The electronic records demonstrated that 95% of the management strategies recorded in the physician questionnaires were implemented as planned. MRI and/or CT were performed within one month of the FDG-PET/CT in 20/83 (24%) and 28/83 (34%) cases, respectively. FDG-PET/CT detected nodes suspicious for metastases on 29/83 (35%) studies performed. MRI and CT detected positive nodes on 6 and 11 studies respectively. Distant metastases were identified in 10 cases imaged with FDG-PET and 5 cases that had additional conventional CT imaging. All suspicious lesions seen on CT were positively identified on PET/CT. In 4 cases, an abnormality identified on PET/CT, was not seen on diagnostic CT.
  
  
  CONCLUSIONS
  FDG-PET/CT may play an important role in the management of vulvar and vaginal carcinoma.
authors.affiliation: Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Av, room C278, New York, NY 10065, USA. Electronic address: Robertn1@mskcc.org.
authors.forename: N L
authors.initials: NL
authors.lastname: Robertson
authors.affiliation: Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Av, room C278, New York, NY 10065, USA.
authors.forename: H
authors.initials: H
authors.lastname: Hricak
authors.affiliation: Gynecologic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Y
authors.initials: Y
authors.lastname: Sonoda
authors.affiliation: Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Av, room C278, New York, NY 10065, USA.
authors.forename: R E
authors.initials: RE
authors.lastname: Sosa
authors.affiliation: Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Av, room C278, New York, NY 10065, USA.
authors.forename: M
authors.initials: M
authors.lastname: Benz
authors.affiliation: Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Av, room C278, New York, NY 10065, USA.
authors.forename: G
authors.initials: G
authors.lastname: Lyons
authors.affiliation: Gynecologic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: N R
authors.initials: NR
authors.lastname: Abu-Rustum
authors.affiliation: Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Av, room C278, New York, NY 10065, USA.
authors.forename: E
authors.initials: E
authors.lastname: Sala
authors.affiliation: Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Av, room C278, New York, NY 10065, USA.
authors.forename: H A
authors.initials: HA
authors.lastname: Vargas
mesh_terms: D002277:Carcinoma / Q000175:diagnosis* / Q000556:secondary / Q000628:therapy; D019468:Disease Management; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008207:Lymphatic Metastasis; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D011379:Prognosis; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014625:Vaginal Neoplasms / Q000175:diagnosis* / Q000628:therapy; D014846:Vulvar Neoplasms / Q000175:diagnosis* / Q000628:therapy
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18