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KMID : 1148920120460010041
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Nuclear Medicine and Molecular Imaging
2012 Volume.46 No. 1 p.41 ~ p.47
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Retrocrural Lymph Node Metastasis Disclosed by 18F-FDG PET/CT: A Predictor of Supra-diaphragmatic Spread in Ovarian Cancer
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Im Hyung-Jun
Kim Yong-Il
Paeng Jin-Chul
Chung June-Key
Kang Soon-Beom
Lee Dong-Soo
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Abstract
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Purpose: Retrocrural lymph nodes (RCLNs) communicate with retroperitoneal and posterior mediastinal LNs. It is possible that, when RCLNs are involved, supra-diaphragmatic extension will occur in abdomino-pelvic cancers. The authors investigated performance of 18F-FDG PET/CT to diagnose RCLN metastasis and whether RCLN metastases were associated with supra-diaphragmatic lymphatic metastases of ovarian cancer.
Materials and methods: Sixty-seven patients with stage IV ovarian cancer who had undergone 18F-FDG PET/CT were included in this retrospective study. Diagnostic performance of 18F-FDG PET/CT for RCLN metastasis was evaluated. Patients were divided into two groups by presence or absence of supra-diaphragmatic LN metastasis. The prevalences of RCLN metastasis between the two groups were compared and the odds ratio was calculated.
Results: Sensitivity and specificity of 18F-FDG PET/CT for RCLN metastasis were 96.3 and 100%, respectively. Of the 67 study subjects, 27 patients had RCLN metastases (40.3%). Fifty patients had supra-diaphragmatic LN metastases. 18F-FDG PET/CT showed 26 RCLN metastases in patients with supra-diaphragmatic LN metastases (54.5%), and only 1 in patients without supra-diaphragmatic LN metastasis (5.9%), and the difference between two groups was statistically significant (P?
Conclusion: Performance of 18F-FDG PET/CT to diagnose RCLN metastasis was excellent. RCLN metastasis revealed by 18F-FDG PET/CT was strongly associated with supra-diaphragmatic LN spread of ovarian cancer. Thus, RCLN metastasis could be used as a predictor of supra-diaphragmatic lymphatic metastasis of ovarian cancer.
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KEYWORD
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F-FDG, PET/CT, Ovarian cancer, Retrocrural lymph node, Lymphatic metastasis
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