Author/Authors :
Mahmoud، Hemat A. نويسنده Department of Clinical Oncology and Nuclear Medicine, Assiut University Hospital, Assiut, Egypt , , Atta، Haisam نويسنده Department of Radiology, South Egypt Cancer Institute, Assiut University, Assiut, Egypt , , Diab، Waleed A. نويسنده Department of Clinical Oncology and Nuclear Medicine, Assiut University Hospital, Assiut, Egypt , , Eloteify، Lamiaa M. نويسنده Department of Clinical Oncology and Nuclear Medicine, Assiut University Hospital, Assiut, Egypt , , Elmonem Mourad، Abd نويسنده Department of Radiology, Assiut University Hospital, Assiut, Egypt , , Gabr، Adel نويسنده Department of Medical Oncology, South Egypt Cancer Institute, Assiut University, Assiut, Egypt , , A. Mekkawy، Mohamed نويسنده Department of Clinical Oncology and Nuclear Medicine, Assiut University Hospital, Assiut, Egypt , , M. Omar، Waleed نويسنده Department of Nuclear Medicine, National Cancer Institute, Cairo University, Cairo, Egypt ,
Abstract :
Background: This study attempts to ascertain a reliable cutoff size to determine
whether pelvic lymph nodes are metastatic or not in ovarian cancer patients.
Methods: We retrospectively reviewed 73 PET/CT scans of 52 female patients with
ovarian carcinoma who underwent surgery followed by chemotherapy. The findings
of contrast enhanced MDCT were interpreted by two experienced radiologists unaware
of the PET/CT findings. At least two experienced nuclear medicine physicians unaware
of the contrast enhanced-MDCT findings examined the PET scans in order to localize,
characterize and compare these scans to co-registered PET/CT images. A comparative
study was done. Lymph node sizes were recorded in short axis diameter with a
significant cut off estimated at 7.5 mm. Metabolic activities of different lymph node
groups were assessed and the semi-quantitative SUV was calculated. The level of SUV
significance was 2.5. Significant metastatic lymph nodes were judged by the assessment
of integrated PET/CT results.
Results: Of the 73 scans, 47 showed significant lymph node metastases, with the
following sensitivities: 75% (external iliac), 77.8% (internal iliac), and 75% (inguinal).
The specificities were 84% (external iliac), 86% (internal iliac), and 54% (inguinal)
with a P-value of 0.000 for the external an internal iliac groups and 0.079 for the inguinal
group.
Conclusion: To improve detection of malignant pelvic lymph nodes, the size
threshold should be decreased to 7.5 mm.
