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Usefulness and potential pitfalls of pre-operative PET-CT in patients with endometrial cancer undergoing one- and two-step sentinel lymph node mapping: Do negative findings on PET-CT negativity really indicate node negativity?

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dc.contributor.author강원준-
dc.contributor.author김영태-
dc.contributor.author남은지-
dc.contributor.author이정윤-
dc.contributor.author김상운-
dc.contributor.author김성훈-
dc.contributor.author이용재-
dc.contributor.author김유나-
dc.contributor.author차종태-
dc.date.accessioned2022-12-22T04:03:18Z-
dc.date.available2022-12-22T04:03:18Z-
dc.date.issued2022-09-
dc.identifier.issn0090-8258-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/192025-
dc.description.abstractObjective: We investigated the utility of Positron emission tomography-Computed tomography (PET-CT) in the setting of two different sentinel lymph node (SLN) mapping techniques; the conventional cervical injection method (one-step) and the two-step method, which involves fundal injection followed by cervical injection. Methods: Patients with endometrial cancer undergoing FDG PET-CT followed by laparoscopic or robotic surgical staging with SLN mapping at the Yonsei Cancer Center between July 2014 and April 2021 were stratified into the PET-positive group (with suspected or likely lymph nodes metastasis) and PET-negative group. A chart review was performed for the number of harvested SLNs, patterns of SLN metastases, and recurrence. Results: Among 466 patients undergoing one-step (n = 276) and two-step (n = 190) SLN mapping, LN metastasis was identified in 21 of 434 PET-negative and 18 of 32 PET-positive patients. The sensitivity and specificity of PET-CT for diagnosing lymph node metastasis were 46.2% and 96.7%, respectively. Among PET-positive patients with LN metastasis, anatomical distribution was concordant in 14/18 patients (77.8%). Among PET-negative patients, four (2.3%) had metastatic para-aortic SLNs, including three (1.7%) with isolated para-aortic metastases; metastatic para-aortic SLNs were exclusively found in the two-step group. Among PET-positive patients, para-aortic SLN metastasis was identified in 35.7% of two-step and 16.7% of one-step group. Among the 21 PET false-negative patients, recurrence was seen in four patients (19%) after a median follow-up of 34 months (range: 7-70 months). Conclusions: PET-CT served as a useful guide to clinicians with high anatomical concordance rate in patients with LN metastasis. However, despite high specificity, sensitivity was limited. SLN metastasis pattern, especially at the para-aortic level, indicates that the two-step SLN technique might be useful in PET-negative and PET-positive patients.-
dc.description.statementOfResponsibilityrestriction-
dc.languageEnglish-
dc.publisherAcademic Press-
dc.relation.isPartOfGYNECOLOGIC ONCOLOGY-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.subject.MESHEndometrial Neoplasms* / diagnostic imaging-
dc.subject.MESHEndometrial Neoplasms* / pathology-
dc.subject.MESHEndometrial Neoplasms* / surgery-
dc.subject.MESHFemale-
dc.subject.MESHHumans-
dc.subject.MESHLymph Node Excision-
dc.subject.MESHLymph Nodes / diagnostic imaging-
dc.subject.MESHLymph Nodes / pathology-
dc.subject.MESHLymph Nodes / surgery-
dc.subject.MESHLymphatic Metastasis / diagnostic imaging-
dc.subject.MESHLymphatic Metastasis / pathology-
dc.subject.MESHPositron Emission Tomography Computed Tomography / methods-
dc.subject.MESHSentinel Lymph Node Biopsy / methods-
dc.subject.MESHSentinel Lymph Node* / diagnostic imaging-
dc.subject.MESHSentinel Lymph Node* / pathology-
dc.subject.MESHSentinel Lymph Node* / surgery-
dc.titleUsefulness and potential pitfalls of pre-operative PET-CT in patients with endometrial cancer undergoing one- and two-step sentinel lymph node mapping: Do negative findings on PET-CT negativity really indicate node negativity?-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Nuclear Medicine (핵의학교실)-
dc.contributor.googleauthorYoo-Na Kim-
dc.contributor.googleauthorDahye Lee-
dc.contributor.googleauthorJongtae Cha-
dc.contributor.googleauthorWon Jun Kang-
dc.contributor.googleauthorYong Jae Lee-
dc.contributor.googleauthorJung-Yun Lee-
dc.contributor.googleauthorEun Ji Nam-
dc.contributor.googleauthorSunghoon Kim-
dc.contributor.googleauthorYoung Tae Kim-
dc.contributor.googleauthorSang Wun Kim-
dc.identifier.doi10.1016/j.ygyno.2022.07.015-
dc.contributor.localIdA00062-
dc.contributor.localIdA00729-
dc.contributor.localIdA01262-
dc.contributor.localIdA04638-
dc.contributor.localIdA00526-
dc.contributor.localIdA00595-
dc.contributor.localIdA05165-
dc.relation.journalcodeJ00956-
dc.identifier.eissn1095-6859-
dc.identifier.pmid35907682-
dc.identifier.urlhttps://www.sciencedirect.com/science/article/pii/S0090825822004875?via%3Dihub-
dc.subject.keywordEndometrial neoplasms-
dc.subject.keywordLymphatic metastasis-
dc.subject.keywordPositron emission tomography-computed tomography-
dc.subject.keywordSentinel lymph node biopsy-
dc.contributor.alternativeNameKang, Won Jun-
dc.contributor.affiliatedAuthor강원준-
dc.contributor.affiliatedAuthor김영태-
dc.contributor.affiliatedAuthor남은지-
dc.contributor.affiliatedAuthor이정윤-
dc.contributor.affiliatedAuthor김상운-
dc.contributor.affiliatedAuthor김성훈-
dc.contributor.affiliatedAuthor이용재-
dc.citation.volume166-
dc.citation.number3-
dc.citation.startPage438-
dc.citation.endPage443-
dc.identifier.bibliographicCitationGYNECOLOGIC ONCOLOGY, Vol.166(3) : 438-443, 2022-09-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers

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