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Endometrial kanserde preoperatif lenf nodu metastazi tespiti: Endometrial kanserde 18-FDG PET/BT'nin rolü

Yıl 2019, Cilt: 3 Sayı: 9, 681 - 684, 01.09.2019

Mustafa Taş Adem Yavuz Mehmet Dolanbay Eser Kaya Gökalp Öner Bülent Özçelik

https://doi.org/10.28982/josam.619609

Öz

Amaç: Fluorine-18 2-floro-2-deoksi-D-glukoz (FDG) pozitron emisyon tomografisi (PET)/ BT görüntüleme tekniği, lokalizasyonun ve fonksiyonel görüntülemenin avantajlarını birleştirdiğinden, endometrial kanserli hastalarda lenf nodu (LN) metastazlarının tespiti için tercih edilen bir yöntem haline gelmiştir. Bu çalışmada 18F-FDG PET/BT görüntüleme sonuçlarının, endometrial kanserin lenf nodu metastazının belirlenmesindeki etkinliğini araştırmayı amaçladık. 

Yöntemler: Bu çalışma 2009-2015 yılları arasında yapılan retrospektif kohort bir çalışmadır. Çalışma grubu kliniğimize başvuran ve endometriyal kanser tanısı alan tüm kadınlardan (n=135) oluşmaktaydı. Çalışmaya, ameliyat öncesi 18F-FDG PET/BT çekilen ve LN diseksiyonu yapılan hastaları dahil edildi. Bu yöntemin lend nodu metastazını belirlemede etkinliği değerlendirildi. Değerlendirmeler ve karşılaştırmalar altın standard patolojik tanı yöntemleriyle yapıldı. 

Bulgular: Lenf nodu metastazlarının tanımlanmasında 18F-FDG PET/BT yönteminin %76 duyarlılık, %80 özgüllük, %46.34 pozitif prediktif değeri ve %93.62 negatif prediktif değeri gösterdiği bulundu. Genel tanısal doğruluk ise %79,26 idi.

Sonuç: Analizlerimiz, 18F-FDG PET/BT'nin, endometriyal kanser hastalarında lenf nodu metastazı açısından yüksek negatif prediktif değere sahip olduğunu ve bu hastalarda lenf nodu metastazı araştırmada uygulanabilir bir görüntüleme yöntemi olduğunu göstermiştir.

Anahtar Kelimeler

Endometrial kanser Lenf nodu metastazı 18F-FDG-PET/BT Prognoz

Kaynakça

  • 1. Lortet-Tieulet J, Ferlay J, Bray F, Jemal A. International Patterns and Trends in Endometrial Cancer Incidence, 1978–2013. J Natl Cancer Inst. 2017;110:354-61.
  • 2. Denschlag DU, Emons G. The diagnosis and treatment of endometrial cancer: progress and controversies. Dtsch Arztebl Int. 2011;108:571-7.
  • 3. Tran AQ, Gehrig P. Recent Advances in Endometrial Cancer. F1000Research. 2017;6:81.
  • 4. Uharcek P. Prognostic factors in endometrial carcinoma. J Obstet Gynaecol Res. 2008;34:776-83.
  • 5. Tschernichovsky R, Diver EJ, Schorge JO, Goodman A. The Role of Lymphadenectomy Versus Sentinel Lymph Node Biopsy in Early-stage Endometrial Cancer: A Review of the Literature. Am J Clin Oncol. 2016;39:516-21.
  • 6. Nayyar N, Lakhwani P, Goel A, Pande PK, Kumar K. The Futility of Systematic Lymphadenectomy in Early-Stage Low-grade Endometrial Cancer. Indian J Surg Oncol. 2018;9:204-10.
  • 7. Kyrgiou M, Swart AM, Qian W, Warwick J. A Comparison of Outcomes Following Laparoscopic and Open Hysterectomy With or Without Lymphadenectomy for Presumed Early-Stage Endometrial Cancer: Results From the Medical Research Council ASTEC Trial. Int J Gynecol Cancer. 2015;25:1424-36.
  • 8. El-Agwany AS, Meleis MH. Value and best way for detection of Sentinel lymph node in early stage endometrial cancer: Selective lymphadenectomy algorithm. Eur J Obstet Gynecol Reprod Biol. 2018;225:35-9.
  • 9. Soneji ND, Bharwani N, Ferri A, Stewart V, Rockall A. Pre-operative MRI staging of endometrial cancer in a multicentre cancer network: can we match single centre study results? Eur Radio. 2018;28:4725-34.
  • 10. Kim HJ, Cho A, Yun M, Kim YT, Kank WJ. Comparison of FDG PET/CT and MRI in lymph node staging of endometrial cancer. Ann Nucl Med. 2016;30:104-13.
  • 11. Sala E, Rockall AG, Freemen SJ, Mitchell DG, Reinhod C. The added role of MR imaging in treatment stratification of patients with gynecologic malignancies: what the radiologist needs to know. Radiology. 2013;266:717-40.
  • 12. Bollineni VR, Ytre-Hauge S, Bollineni-Balabay O, Salvesen HB, Haldorsen IS. High Diagnostic Value of 18F-FDG PET/CT in Endometrial Cancer: Systematic Review and Meta-Analysis of the Literature. J Nucl Med. 2016;57:879-85.
  • 13. Sager O, Dincoglan F, Demiral S, Uysal B, Gamsiz H, Elcim Y, et al. Utility Of Molecular Imaging With 2-Deoxy-2-[Fluorine-18] Fluoro-D-Glucose Positron Emission Tomography (18f-Fdg Pet) For Small Cell Lung Cancer (Sclc): A Radiation Oncology Perspective. Curr Radiopharm. 2018.
  • 14. Beinat C, Haywood T, Chen YS, Patel CB, Alam IS, Murty S, et al. The Utility of [(18)F]DASA-23 for Molecular Imaging of Prostate Cancer with Positron Emission Tomography. Mol Imaging Biol. 2018;20:1015-24.
  • 15. Gambhir SS, Molecular imaging of cancer with positron emission tomography. Nat Rev Cancer. 2002;2:683-93.
  • 16. Kitajima K, Suenaga Y, Ueno Y, Maeda T, Ebina Y, Yamada H, et al. Preoperative risk stratification using metabolic parameters of (18)F-FDG PET/CT in patients with endometrial cancer. Eur J Nucl Med Mol Imaging. 2015;42:1268-75.
  • 17. Dolanbay M, Ozcelik B, Abdulrezzak U, Serin İS, Uludag S. F-18 fluoro-D-glucose (FDG)-positron emission tomography (PET)/computed tomography (CT) in planning of surgery and sentinel lymph node screening in vulvar cancers. Arch Gynecol Obstet. 2016;293:1319-24.
  • 18. Picchio M, Mangili G, Samanes Gajate AM, De Marzi P, Spinapolice EG, Mapelli P, et al. High-grade endometrial cancer: value of [(18)F]FDG PET/CT in preoperative staging. Nucl Med Commun. 2010;31:506-12.
  • 19. Chang MC, Chen JH, Liang JA, Yang KT, Cheng KY, Kao CH. 18F-FDG PET or PET/CT for detection of metastatic lymph nodes in patients with endometrial cancer: A systematic review and meta-analysis. European Journal of Radiology. 2012;81:3511-7.
  • 20. Atri M, Zhang Z, Dehdashti F, Lee SI, Marques H, Ali S, et al. Utility of PET/CT to Evaluate Retroperitoneal Lymph Node Metastasis in High-Risk Endometrial Cancer: Results of ACRIN 6671/GOG 0233 Trial. Radiology. 2017;283:450-9.
  • 21. Lee SI, Russell AH. Performance of 18F-FDG PET/CT in Endometrial Cancer. American Journal of Roentgenology. 2008;191:W210.
  • 22. Crivellaro C, Signorelli M, Guerra L, De Ponti E, Pirovano C, Fruscio R, et al. Tailoring systematic lymphadenectomy in high-risk clinical early stage endometrial cancer: the role of 18F-FDG PET/CT. Gynecol Oncol. 2013;130:306-11.
  • 23. Signorelli M, Guerra L, Buda A, Picchio M, Mangili G, Dell'Anna T, et al. Role of the integrated FDG PET/CT in the surgical management of patients with high risk clinical early stage endometrial cancer: detection of pelvic nodal metastases. Gynecol Oncol. 2009;115:231-5.
  • 24. Suga T, Nakamoto Y, Saga T, Higashi T, Hamanaka Y, Tatsumi M, et al. Clinical value of FDG-PET for preoperative evaluation of endometrial cancer. Ann Nucl Med. 2011;25:269-75.
  • 25. Nakamura K, Hongo A, Kodoma J, Hiramatsu Y. The measurement of SUVmax of the primary tumor is predictive of prognosis for patients with endometrial cancer. Gynecol Oncol. 2011;123:82-7.
  • 26. Nogami Y, Banno K, Irie H, Iida M, Kisu I, Masugi Y, et al. The efficacy of preoperative positron emission tomography-computed tomography (PET-CT) for detection of lymph node metastasis in cervical and endometrial cancer: clinical and pathological factors influencing it. Jpn J Clin Oncol. 2014;45:26-34.
  • 27. H Horowitz NS, Dehdashti F, Herzog TJ, Rader JS, Powell MA, Gibb RK, et al. Prospective evaluation of FDG-PET for detecting pelvic and para-aortic lymph node metastasis in uterine corpus cancer. Gynecol Oncol. 2004;95:546-51.
  • 28. Antonsen SL, Loft A, Fisker R, Nielsen AL, Andersen ES, Høgdall E, et al. SUVmax of 18FDG PET/CT as a predictor of high-risk endometrial cancer patients. Gynecol Oncol. 2013;129:298-303.
  • 29. Sironi S, Buda A, Picchio M, Perego P, Moreni R, Pellegrino A, et al. Lymph Node Metastasis in Patients with Clinical Early-Stage Cervical Cancer: Detection with Integrated FDG PET/CT. Radiology. 2006;238:272-9.
  • 30. Reinhardt, MJ, Ehritt-Braun C, Vogelgesang D. Metastatic Lymph Nodes in Patients with Cervical Cancer: Detection with MR Imaging and FDG PET. Radiology. 2001;218:776-82.
  • 31. Sironi S, Messa C, Mangili G. Integrated FDG PET/CT in Patients with Persistent Ovarian Cancer: Correlation with Histologic Findings. Radiology. 2004;233:433-40.

Preoperative detection of lymph node metastasis in endometrial cancer: The role of 18-FDG PET/CT

Yıl 2019, Cilt: 3 Sayı: 9, 681 - 684, 01.09.2019

Mustafa Taş Adem Yavuz Mehmet Dolanbay Eser Kaya Gökalp Öner Bülent Özçelik

https://doi.org/10.28982/josam.619609

Öz

Aim: Fluorine-18 2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET)/CT imaging technique combines the advantages of localization and functional imaging, and thus has become a preferred method for detection of metastases to the lymph nodes (LN) of patients with endometrial cancer. The aim of this study was to evaluate the efficacy of 18F-FDG PET/CT imaging results in the detection of metastasis of endometrial cancer to lymph nodes.

Methods: This is a retrospective cohort study conducted between 2009 and 2015. The study group consisted of females who were admitted to our clinic and diagnosed with endometrial cancer (n=135). We included patients who underwent LN dissection with pre-operative 18F-FDG PET / CT imaging, and evaluated the capability of this method in terms of its effectiveness in determining metastases to the lymph nodes. Assessments and comparisons were performed with gold-standard pathological methods. 

Results: The 18F-FDG PET/CT method for identification of lymph node metastases had a sensitivity of 76%, a specificity of 80%, a positive predictive value of 46.34% and a negative predictive value of 93.62%. The overall diagnostic accuracy was 79.26%.

Conclusion: Our analysis suggests that 18F-FDG PET/CT has a high negative predictive value with regards to lymph node metastasis in endometrial cancer and may be used effectively in evaluating lymph node metastasis in this cohort.

Anahtar Kelimeler

Endometrial cancer Lymph node metastasis 18F- FDG-PET/CT Ratio Prognosis

Kaynakça

  • 1. Lortet-Tieulet J, Ferlay J, Bray F, Jemal A. International Patterns and Trends in Endometrial Cancer Incidence, 1978–2013. J Natl Cancer Inst. 2017;110:354-61.
  • 2. Denschlag DU, Emons G. The diagnosis and treatment of endometrial cancer: progress and controversies. Dtsch Arztebl Int. 2011;108:571-7.
  • 3. Tran AQ, Gehrig P. Recent Advances in Endometrial Cancer. F1000Research. 2017;6:81.
  • 4. Uharcek P. Prognostic factors in endometrial carcinoma. J Obstet Gynaecol Res. 2008;34:776-83.
  • 5. Tschernichovsky R, Diver EJ, Schorge JO, Goodman A. The Role of Lymphadenectomy Versus Sentinel Lymph Node Biopsy in Early-stage Endometrial Cancer: A Review of the Literature. Am J Clin Oncol. 2016;39:516-21.
  • 6. Nayyar N, Lakhwani P, Goel A, Pande PK, Kumar K. The Futility of Systematic Lymphadenectomy in Early-Stage Low-grade Endometrial Cancer. Indian J Surg Oncol. 2018;9:204-10.
  • 7. Kyrgiou M, Swart AM, Qian W, Warwick J. A Comparison of Outcomes Following Laparoscopic and Open Hysterectomy With or Without Lymphadenectomy for Presumed Early-Stage Endometrial Cancer: Results From the Medical Research Council ASTEC Trial. Int J Gynecol Cancer. 2015;25:1424-36.
  • 8. El-Agwany AS, Meleis MH. Value and best way for detection of Sentinel lymph node in early stage endometrial cancer: Selective lymphadenectomy algorithm. Eur J Obstet Gynecol Reprod Biol. 2018;225:35-9.
  • 9. Soneji ND, Bharwani N, Ferri A, Stewart V, Rockall A. Pre-operative MRI staging of endometrial cancer in a multicentre cancer network: can we match single centre study results? Eur Radio. 2018;28:4725-34.
  • 10. Kim HJ, Cho A, Yun M, Kim YT, Kank WJ. Comparison of FDG PET/CT and MRI in lymph node staging of endometrial cancer. Ann Nucl Med. 2016;30:104-13.
  • 11. Sala E, Rockall AG, Freemen SJ, Mitchell DG, Reinhod C. The added role of MR imaging in treatment stratification of patients with gynecologic malignancies: what the radiologist needs to know. Radiology. 2013;266:717-40.
  • 12. Bollineni VR, Ytre-Hauge S, Bollineni-Balabay O, Salvesen HB, Haldorsen IS. High Diagnostic Value of 18F-FDG PET/CT in Endometrial Cancer: Systematic Review and Meta-Analysis of the Literature. J Nucl Med. 2016;57:879-85.
  • 13. Sager O, Dincoglan F, Demiral S, Uysal B, Gamsiz H, Elcim Y, et al. Utility Of Molecular Imaging With 2-Deoxy-2-[Fluorine-18] Fluoro-D-Glucose Positron Emission Tomography (18f-Fdg Pet) For Small Cell Lung Cancer (Sclc): A Radiation Oncology Perspective. Curr Radiopharm. 2018.
  • 14. Beinat C, Haywood T, Chen YS, Patel CB, Alam IS, Murty S, et al. The Utility of [(18)F]DASA-23 for Molecular Imaging of Prostate Cancer with Positron Emission Tomography. Mol Imaging Biol. 2018;20:1015-24.
  • 15. Gambhir SS, Molecular imaging of cancer with positron emission tomography. Nat Rev Cancer. 2002;2:683-93.
  • 16. Kitajima K, Suenaga Y, Ueno Y, Maeda T, Ebina Y, Yamada H, et al. Preoperative risk stratification using metabolic parameters of (18)F-FDG PET/CT in patients with endometrial cancer. Eur J Nucl Med Mol Imaging. 2015;42:1268-75.
  • 17. Dolanbay M, Ozcelik B, Abdulrezzak U, Serin İS, Uludag S. F-18 fluoro-D-glucose (FDG)-positron emission tomography (PET)/computed tomography (CT) in planning of surgery and sentinel lymph node screening in vulvar cancers. Arch Gynecol Obstet. 2016;293:1319-24.
  • 18. Picchio M, Mangili G, Samanes Gajate AM, De Marzi P, Spinapolice EG, Mapelli P, et al. High-grade endometrial cancer: value of [(18)F]FDG PET/CT in preoperative staging. Nucl Med Commun. 2010;31:506-12.
  • 19. Chang MC, Chen JH, Liang JA, Yang KT, Cheng KY, Kao CH. 18F-FDG PET or PET/CT for detection of metastatic lymph nodes in patients with endometrial cancer: A systematic review and meta-analysis. European Journal of Radiology. 2012;81:3511-7.
  • 20. Atri M, Zhang Z, Dehdashti F, Lee SI, Marques H, Ali S, et al. Utility of PET/CT to Evaluate Retroperitoneal Lymph Node Metastasis in High-Risk Endometrial Cancer: Results of ACRIN 6671/GOG 0233 Trial. Radiology. 2017;283:450-9.
  • 21. Lee SI, Russell AH. Performance of 18F-FDG PET/CT in Endometrial Cancer. American Journal of Roentgenology. 2008;191:W210.
  • 22. Crivellaro C, Signorelli M, Guerra L, De Ponti E, Pirovano C, Fruscio R, et al. Tailoring systematic lymphadenectomy in high-risk clinical early stage endometrial cancer: the role of 18F-FDG PET/CT. Gynecol Oncol. 2013;130:306-11.
  • 23. Signorelli M, Guerra L, Buda A, Picchio M, Mangili G, Dell'Anna T, et al. Role of the integrated FDG PET/CT in the surgical management of patients with high risk clinical early stage endometrial cancer: detection of pelvic nodal metastases. Gynecol Oncol. 2009;115:231-5.
  • 24. Suga T, Nakamoto Y, Saga T, Higashi T, Hamanaka Y, Tatsumi M, et al. Clinical value of FDG-PET for preoperative evaluation of endometrial cancer. Ann Nucl Med. 2011;25:269-75.
  • 25. Nakamura K, Hongo A, Kodoma J, Hiramatsu Y. The measurement of SUVmax of the primary tumor is predictive of prognosis for patients with endometrial cancer. Gynecol Oncol. 2011;123:82-7.
  • 26. Nogami Y, Banno K, Irie H, Iida M, Kisu I, Masugi Y, et al. The efficacy of preoperative positron emission tomography-computed tomography (PET-CT) for detection of lymph node metastasis in cervical and endometrial cancer: clinical and pathological factors influencing it. Jpn J Clin Oncol. 2014;45:26-34.
  • 27. H Horowitz NS, Dehdashti F, Herzog TJ, Rader JS, Powell MA, Gibb RK, et al. Prospective evaluation of FDG-PET for detecting pelvic and para-aortic lymph node metastasis in uterine corpus cancer. Gynecol Oncol. 2004;95:546-51.
  • 28. Antonsen SL, Loft A, Fisker R, Nielsen AL, Andersen ES, Høgdall E, et al. SUVmax of 18FDG PET/CT as a predictor of high-risk endometrial cancer patients. Gynecol Oncol. 2013;129:298-303.
  • 29. Sironi S, Buda A, Picchio M, Perego P, Moreni R, Pellegrino A, et al. Lymph Node Metastasis in Patients with Clinical Early-Stage Cervical Cancer: Detection with Integrated FDG PET/CT. Radiology. 2006;238:272-9.
  • 30. Reinhardt, MJ, Ehritt-Braun C, Vogelgesang D. Metastatic Lymph Nodes in Patients with Cervical Cancer: Detection with MR Imaging and FDG PET. Radiology. 2001;218:776-82.
  • 31. Sironi S, Messa C, Mangili G. Integrated FDG PET/CT in Patients with Persistent Ovarian Cancer: Correlation with Histologic Findings. Radiology. 2004;233:433-40.
Toplam 31 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Kadın Hastalıkları ve Doğum
Bölüm Araştırma makalesi
Yazarlar

Mustafa Taş 0000-0001-7183-0026

Adem Yavuz Bu kişi benim 0000-0003-4191-4004

Mehmet Dolanbay 0000-0002-8332-1568

Eser Kaya Bu kişi benim 0000-0003-2931-9974

Gökalp Öner Bu kişi benim 0000-0002-6270-4340

Bülent Özçelik 0000-0003-3257-8088

Yayımlanma Tarihi 1 Eylül 2019
Yayımlandığı Sayı Yıl 2019 Cilt: 3 Sayı: 9

Kaynak Göster

APA Taş, M., Yavuz, A., Dolanbay, M., Kaya, E., vd. (2019). Preoperative detection of lymph node metastasis in endometrial cancer: The role of 18-FDG PET/CT. Journal of Surgery and Medicine, 3(9), 681-684. https://doi.org/10.28982/josam.619609
AMA Taş M, Yavuz A, Dolanbay M, Kaya E, Öner G, Özçelik B. Preoperative detection of lymph node metastasis in endometrial cancer: The role of 18-FDG PET/CT. J Surg Med. Eylül 2019;3(9):681-684. doi:10.28982/josam.619609
Chicago Taş, Mustafa, Adem Yavuz, Mehmet Dolanbay, Eser Kaya, Gökalp Öner, ve Bülent Özçelik. “Preoperative Detection of Lymph Node Metastasis in Endometrial Cancer: The Role of 18-FDG PET/CT”. Journal of Surgery and Medicine 3, sy. 9 (Eylül 2019): 681-84. https://doi.org/10.28982/josam.619609.
EndNote Taş M, Yavuz A, Dolanbay M, Kaya E, Öner G, Özçelik B (01 Eylül 2019) Preoperative detection of lymph node metastasis in endometrial cancer: The role of 18-FDG PET/CT. Journal of Surgery and Medicine 3 9 681–684.
IEEE M. Taş, A. Yavuz, M. Dolanbay, E. Kaya, G. Öner, ve B. Özçelik, “Preoperative detection of lymph node metastasis in endometrial cancer: The role of 18-FDG PET/CT”, J Surg Med, c. 3, sy. 9, ss. 681–684, 2019, doi: 10.28982/josam.619609.
ISNAD Taş, Mustafa vd. “Preoperative Detection of Lymph Node Metastasis in Endometrial Cancer: The Role of 18-FDG PET/CT”. Journal of Surgery and Medicine 3/9 (Eylül 2019), 681-684. https://doi.org/10.28982/josam.619609.
JAMA Taş M, Yavuz A, Dolanbay M, Kaya E, Öner G, Özçelik B. Preoperative detection of lymph node metastasis in endometrial cancer: The role of 18-FDG PET/CT. J Surg Med. 2019;3:681–684.
MLA Taş, Mustafa vd. “Preoperative Detection of Lymph Node Metastasis in Endometrial Cancer: The Role of 18-FDG PET/CT”. Journal of Surgery and Medicine, c. 3, sy. 9, 2019, ss. 681-4, doi:10.28982/josam.619609.
Vancouver Taş M, Yavuz A, Dolanbay M, Kaya E, Öner G, Özçelik B. Preoperative detection of lymph node metastasis in endometrial cancer: The role of 18-FDG PET/CT. J Surg Med. 2019;3(9):681-4.
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