Staging of primary cervical cancers: the role of nuclear medicine

Crit Rev Oncol Hematol. 2003 Jun;46(3):275-84. doi: 10.1016/s1040-8428(03)00027-1.

Abstract

In nuclear medicine, [18F]-fluorodeoxyglucose positron emission tomography (18FDG PET) and lymphatic mapping and sentinel lymphadenectomy (LM/SL) may significantly improve the staging of primary cervical cancers. Indeed, the disease progresses in a 'level by level' fashion to regional nodes through the lymphatic channels, and also to extra-nodal sites via the hematogenous stream. Additionally, the sub-optimal efficacy of routine radiological protocols, while new combined therapies are proving to be more efficient, stresses the need for alternative staging procedures. Current data suggest that LM/SL accurately reflects the regional lymph node status in early stage cervical cancers, and thus could avoid unnecessary complete lymphadenectomies. Also, whole body 18FDG PET may provide valuable insights on extra-pelvic and distant tumor spreading, with a significant impact on treatment choices. If these promising results are confirmed on large controlled trials, LM/SL and 18FDG PET imaging could be incorporated in the routine staging work-up of primary cervical cancers.

Publication types

  • Review

MeSH terms

  • Female
  • Fluorodeoxyglucose F18
  • Humans
  • Lymph Nodes / diagnostic imaging*
  • Lymph Nodes / pathology*
  • Lymphatic Metastasis / diagnostic imaging
  • Neoplasm Staging / methods
  • Radiopharmaceuticals
  • Sentinel Lymph Node Biopsy
  • Tomography, Emission-Computed* / methods
  • Uterine Cervical Neoplasms / diagnostic imaging*
  • Uterine Cervical Neoplasms / pathology*
  • Uterine Cervical Neoplasms / surgery

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18