Imperial College London
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Prof. Christina Fotopoulou

Faculty of Medicine, Department of Surgery & Cancer

Chair in Gynaecological Cancer Surgery
 
 
 
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c.fotopoulou

 
 
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Location

 

Institute of Reproductive and Developmental BiologyHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Rockall:2021:10.1158/1078-0432.CCR-21-1834,
author = {Rockall, A and Barwick, T and Wilson, W and Singh, N and Bharwani, N and Sohaib, A and Nobbenhuis, M and Warbey, V and Miquel, M and Koh, D-M and De, Paepe KN and Martin-Hirsch, P and Ghaem-Maghami, S and Fotopoulou, C and Stringfellow, H and Sundar, S and Manchanda, R and Sahdev, A and Hackshaw, A and Cook, GJ and MAPPING, Study Group},
doi = {10.1158/1078-0432.CCR-21-1834},
journal = {Clinical Cancer Research},
pages = {6457--6466},
title = {Diagnostic accuracy of FEC-PET/CT, FDG-PET/CT and diffusion-weighted MRI in detection of nodal metastases in surgically treated endometrial and cervical carcinoma},
url = {http://dx.doi.org/10.1158/1078-0432.CCR-21-1834},
volume = {27},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Purpose:Pre-operative nodal staging is important for planning treatment in cervical cancer (CC) and endometrial cancer (EC) but remains challenging.  We compare nodal staging accuracy of 18F-ethyl-choline-(FEC)-PET/CT, 18F-Fluoro-deoxy-glucose-(FDG)-PET/CT and diffusion-weighted-MRI (DW-MRI) with conventional morphological MRI.Experimetal Design:A prospective, multicentre observational study of diagnostic accuracy for nodal metastases was undertaken in 5 gyne-oncology centres.  FEC-PET/CT, FDG-PET/CT and DW-MRI were compared to nodal size and morphology on MRI. Reference standard was strictly correlated nodal histology. Eligibility included operable CC stage=>1B1 or EC (grade 3 any stage with myometrial invasion or grade 1-2 stage=>II). Results:Among 162 consenting participants, 136 underwent study DW-MRI and FDG-PET/CT, and 60 underwent FEC-PET/CT. 267 nodal regions in 118 women were strictly correlated at histology (nodal positivity rate 25%).  Sensitivity per-patient (n=118) for nodal size, morphology, DW-MRI, FDG- and FEC-PET/CT were 40%, 53%, 53%, 63% and 67% for all cases (p=0.016); 10%, 10%, 20%, 30% and 25% in CC (n=40);  65%, 75%, 70%, 80% and 88% in EC (n=78). FDG-PET/CT outperformed nodal size (p=0.006) and size ratio (p=0.04) for per-region sensitivity.  False positive rates were all <10%.  Conclusions:All imaging techniques had low sensitivity for detection of nodal metastases and cannot replace surgical nodal staging.  The performance of FEC-PET/CT was not statistically different to other techniques that are more widely available.  FDG-PET/CT had higher sensitivity than size in detecting nodal metastases.  False positive rates were low across all methods. The low false positive rate demonstrated by FDG-PET/CT may be helpful in arbitration of challenging surgical planning decisions.
AU  - Rockall,A
AU  - Barwick,T
AU  - Wilson,W
AU  - Singh,N
AU  - Bharwani,N
AU  - Sohaib,A
AU  - Nobbenhuis,M
AU  - Warbey,V
AU  - Miquel,M
AU  - Koh,D-M
AU  - De,Paepe KN
AU  - Martin-Hirsch,P
AU  - Ghaem-Maghami,S
AU  - Fotopoulou,C
AU  - Stringfellow,H
AU  - Sundar,S
AU  - Manchanda,R
AU  - Sahdev,A
AU  - Hackshaw,A
AU  - Cook,GJ
AU  - MAPPING,Study Group
DO  - 10.1158/1078-0432.CCR-21-1834
EP  - 6466
PY  - 2021///
SN  - 1078-0432
SP  - 6457
TI  - Diagnostic accuracy of FEC-PET/CT, FDG-PET/CT and diffusion-weighted MRI in detection of nodal metastases in surgically treated endometrial and cervical carcinoma
T2  - Clinical Cancer Research
UR  - http://dx.doi.org/10.1158/1078-0432.CCR-21-1834
UR  - https://clincancerres.aacrjournals.org/content/early/2021/09/14/1078-0432.CCR-21-1834
UR  - http://hdl.handle.net/10044/1/91630
VL  - 27
ER  -
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