Robertson N L, Hricak H, Sonoda Y, Sosa R E, Benz M, Lyons G, Abu-Rustum N R, Sala E, Vargas H A
Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Av, room C278, New York, NY 10065, USA.
Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Av, room C278, New York, NY 10065, USA.
Gynecol Oncol. 2016 Mar;140(3):420-4. doi: 10.1016/j.ygyno.2016.01.011. Epub 2016 Jan 11.
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.
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.
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.
FDG-PET/CT may play an important role in the management of vulvar and vaginal carcinoma.
评估正电子发射断层显像/计算机断层扫描（PET/CT）检查对外阴和阴道癌患者预后印象及患者管理的影响；并比较PET/CT检查结果与传统成像方式的检查结果。
我们对来自本机构的50例连续患者的数据进行了前瞻性和回顾性总结，这些患者参加了国家肿瘤PET登记，并因疑似或已知原发性或复发性外阴/阴道癌接受了氟代脱氧葡萄糖-PET/CT（FDG-PET/CT）检查。
纳入的83项研究中，54项（65%）诊断为外阴癌，其余29项（35%）诊断为阴道癌。FDG-PET/CT检查后，51%的病例医生的预后印象发生了改变。36%的研究记录了患者管理的改变，定义为从非介入性策略（观察或额外成像）转变为介入性策略（活检或治疗），或反之。电子记录显示，医生问卷中记录的95%的管理策略按计划实施。分别有20/83（24%）和28/83（34%）的病例在FDG-PET/CT检查后1个月内进行了磁共振成像（MRI）和/或计算机断层扫描（CT）。在83项检查中的29项（35%）中，FDG-PET/CT检测到可疑转移淋巴结。MRI和CT分别在6项和11项研究中检测到阳性淋巴结。在10例接受FDG-PET成像的病例和5例接受额外传统CT成像的病例中发现了远处转移。CT上所有可疑病变在PET/CT上均得到明确诊断。4例中，PET/CT上发现的异常在诊断性CT上未显示。
FDG-PET/CT在外阴和阴道癌的管理中可能发挥重要作用。
