You're using an outdated browser. Please upgrade to a modern browser for the best experience.
Submitted Successfully!
Thank you for your contribution! You can also upload a video entry or images related to this topic. For video creation, please contact our Academic Video Service.
Version Summary Created by Modification Content Size Created at Operation
1 Eóin Niall Molloy -- 1959 2022-04-22 07:52:45 |
2 update references and layout Amina Yu -8 word(s) 1951 2022-04-22 08:36:32 |

Video Upload Options

We provide professional Academic Video Service to translate complex research into visually appealing presentations. Would you like to try it?
No, upload directly Yes

Confirm

Are you sure to Delete?
Yes No
Cite
If you have any further questions, please contact Encyclopedia Editorial Office.
Molloy, E.; Eppard, E.; Vahidfra, N.; , .; Ahmadzadehfar, H. Nuclear Medicine in the Gynecological Malignancies. Encyclopedia. Available online: https://encyclopedia.pub/entry/22153 (accessed on 05 December 2025).
Molloy E, Eppard E, Vahidfra N,  , Ahmadzadehfar H. Nuclear Medicine in the Gynecological Malignancies. Encyclopedia. Available at: https://encyclopedia.pub/entry/22153. Accessed December 05, 2025.
Molloy, Eóin, Elisabeth Eppard, Nasim Vahidfra,  , Hojjat Ahmadzadehfar. "Nuclear Medicine in the Gynecological Malignancies" Encyclopedia, https://encyclopedia.pub/entry/22153 (accessed December 05, 2025).
Molloy, E., Eppard, E., Vahidfra, N., , ., & Ahmadzadehfar, H. (2022, April 22). Nuclear Medicine in the Gynecological Malignancies. In Encyclopedia. https://encyclopedia.pub/entry/22153
Molloy, Eóin, et al. "Nuclear Medicine in the Gynecological Malignancies." Encyclopedia. Web. 22 April, 2022.
Nuclear Medicine in the Gynecological Malignancies
Edit
This entry is adapted from the peer-reviewed paper 10.3390/cancers14071779

Gynecological malignancies include ovarian, cervical, and endometrial cancer, and greatly affect female health and quality of life worldwide. Despite promising advancements in the detection and the treatment of cancers, there are still uncertainties in the diagnostic methods, which in turn can contribute to patient mortality.

gynecology radiopharmaceutical positron emission tomography/computer tomography (PET/CT) single-photon emission computed tomography/computed tomography (SPECT/CT)

1. Cervical Cancer

Globally, cervical cancer is the second most serious gynecological malignancy in terms of mortality in patients under 35 years of age [1][2]. As a result, numerous ones have been conducted in order to characterize its epidemiology and possible etiology [3][4][5]. A main consideration in the management of cervical cancer is the appropriate staging of access to effective treatment methods and patients’ prognosis [2]. One such consideration is that the detection resolution of tomography/computer tomography (PET/CT) for staging of primary tumors of cervical cancers is limited [2]. Consequently, the use of MRI for imaging tumor volume, size, and the extent of parametrial invasion may be superior, acting as a gold standard for evaluating the locoregional extension of cervical cancer [2][6]. Nevertheless, [18F]FDG PET, provides metabolic information by depicting glycolytic tumor activity, and it can also obtain additional information in the staging of primary cervical cancers [6]. Pawar et al. assessed the success rate of PET/CT in a retrospective one of 56 patients with gynecological malignancy including cervix carcinomas (23 patients). It was shown that PET/CT offers a high diagnostic accuracy, both in the evaluation of suspected tumor recurrence and in persistent disease [7]. It was concluded that PET/CT has particular value in primary cervical cancer, which is related to the diagnosis of extra-pelvic abnormalities, the detection of recurrence, and the monitoring of patients after treatment [7]. In another retrospective analysis of the accuracy of [18F]FDG PET/CT, the rate of success in the initial stages of cervical tumors was estimated to be 100% [8]. Further and clinical observations have demonstrated that the combined PET/CT has greater accuracy compared to PET imaging alone [9][10]. Generally, it has been concluded that [18F]FDG PET/CT is a choice modality for investigations of pretreatment staging and post-treatment surveillance of cervical cancer [11]. One of the most considerable and adverse criteria of cervical cancer is tumor hypoxia [12][13]. Hypoxia is defined as oxygen insufficiency in cells, and it can be used as a prognostic indicator. Hypoxia has shown particular utility in therapeutic cancer management, including responses to chemotherapy or radiation therapy [14][15][16][17]. Another noteworthy aspect of hypoxia is the prediction of metastases in tumor cells which are related to hypoxia’s role in deoxyribonucleic acid (DNA) mutations and malignant, atypical cells [18]. Given these observations, the evaluation of hypoxia in treatment management is essential, particularly for locally advanced stages and local recurrences, which occur more than expected in cervical cancer [19].

2. Ovarian Cancer

In recent years, ovarian cancer has become the fifth most common cause of death among women worldwide [20]. Early detection of ovarian cancer (stage I) leads to successful treatment in more than 90% of cases. However, this percentage dramatically decreases to 20–25% in later stages (III, IV) [21]. Various diagnostic modalities provide diverse clinical information for the diagnosis of the disease [20]. Molecular imaging modalities including SPECT/CT and PET/CT possess functional information about the biochemistry of tissues [20]. Molecular PET imaging agents reflect general information about energy consumption through glucose metabolism ([18F]FDG) or the proliferation of DNA synthesis ([18F]F-fluorodeoxythymidine ([18F]FLT)) [22]. For more specific targeting of the cell surface, components like hormone receptors, receptor tyrosine kinases, angiogenesis components, and immunotherapy components would be invaluable [22]. Many have been conducted to optimize the effective diagnosis and treatment of ovarian cancer. A comparison of 51 patients with peritoneal lesions arising from ovarian cancer demonstrated that obtained visual results of [18F]FDG PET/CT in association with other semi-quantitative parameters were effective in the detection of ovarian cancer [23]. This result was based on the observed differentiation potency of [18F]FDG PET/CT in malignant and benign lesions [23]. In another, results showed that carcinoma antigen 125 (CA125) acted as a sensitive tumor marker of recurrent ovarian cancer in 175 patients with recurrent refractory ovarian cancer and increased CA125. Specifically, it was demonstrated that the detection rate of [18F]FDG PET/CT scan is 90% for elevated CA125 and 53% for a low (<30) but measurable amount of CA125 [24]. These findings show that [18F]FDG PET/CT can detect active lesions despite a low level of CA125, and this can be useful for the early detection and treatment of recurrent cases [24]. Undoubtedly, with increased CA125 (≥35) the diagnostic value of [18F]FDG PET/CT has been well established in numerous on ovarian cancer [25][26]. Generally, it can be argued that [18F]FDG PET/CT is a valuable detection method in suspected recurrent situations, and it acts as a viable prediction tool for the progression of advanced ovarian cancer [27][28][29][30][31]. Despite these beneficial aspects of [18F]FDG PET/CT, however, this procedure doesn’t show reliable diagnostic value in the primary stages of ovarian cancer [22].

2.1. DNA Synthesis and Proliferation Imaging Radiopharmaceuticals for Ovarian Cancer

The radiopharmaceutical, [18F]c, is a tracer for proliferation activity. After internalization, [18F]FLT undergoes phosphorylation by thymidine kinase 1, resulting in sequestrated intracellular radioactivity [32]. Thymidine kinase participates in DNA synthesis and therefore reflects the proliferation rate in tissues. Evidence from both preclinical and clinical ones shows a decrease in [18F]FLT uptake after ovarian cancer treatment [33][34][35]. Moreover, a pilot one demonstrated that prior to the debulking surgery of ovarian cancer in six patients, [18F]FLT showed a higher uptake in tumors compared to normal tissues [35]. Additionally, clinical ones have reported that, due to a high background in liver and bone marrow, administration of [18F]FLT for pretreatment assessments would not be recommended given that it may cover the metastases located adjacent to the mentioned organs with a high background [36].

2.2. Estrogen Receptor Imaging Radiopharmaceuticals for Ovarian Cancer

Previously it has been shown that in estrogen receptor (ER) positive early breast cancer patients, endocrine therapeutic procedures reduce recurrences and the mortality rate, regardless of whether chemotherapy is also applied [37]. Previous clinical trials have also demonstrated that endocrine therapy for ovarian cancer can improve the response to treatment and prolong survival in platinum-resistant ovarian cancer patients [38][39][40][41]. Based on these findings, ER receptors could be a valuable predictor for patients who may benefit from endocrine hormonal therapy [42].
The 16a-[18F]-fluoro-17b-estradiol ([18F]FES) PET/CT has been successfully applied in breast and ovarian cancer; and [18F]FES uptake has shown a high correlation with estrogen receptor (ER) expressions in previous ones [43][44]. In a clinical one on estrogen-receptor-positive primary breast cancer patients, hormonal therapy failure in [18F]FES negative cases was investigated [44]: [18F]FES sensitivity and specificity for detection of ER positive lesions was estimated at 84% to 94% for breast cancer and 79% to 100% for ovarian cancer, respectively [20]. Additionally, [18F]FES has been demonstrated in leiomyoma as well as epithelial ovarian cancer [44][45]. In 15 patients with suspected ovarian cancer, 88% exhibited lesions measurable with CT and that could be diagnosed with [18F]FES PET/CT. The remainder were non-quantifiable due to a high radioactivity uptake of adjacent tissues [45]. These findings support the beneficial role of [18F]FES in hormonal therapy.

2.3. Endometrial Cancer

Endometrial cancer is the most common cancer of the genital tract and the fourth most common malignancy among women in developed countries [46]. Endometrial cancer exhibits a more positive prognosis in that it can often be diagnosed earlier and, for localized occurrences, a five-year survival rate is usually expected (96% of cases) [47]. Nevertheless, overall survival declines to 57% in patients with regional metastasis in pelvic lymph nodes (PLN), and 49.4% in those with metastasis to para-aortic lymph nodes (PALN), with or without positive PLN [48]. Numerous ones have emphasized the unique role of [18F]FDG PET/CT in the assessments of staging, restaging, monitoring, and planning of therapeutic procedures in uterine cancers [49][50][51][52]. The reliability of [18F]FDG PET/CT in the detection of pelvic and/or para aortic lymph nodes metastasis in patients with untreated endometrial cancer was evaluated in several clinical [53][54][55][56], generally showing high efficacy. Furthermore, a meta-analysis [54] also highlighted the utility of [18F]FDG PET/CT in the diagnosis of lymph node metastasis (LNM) in pre-operational investigations and post-operative recurrences of endometrial cancers. In order to verify the post-operational effect of [18F]FDG, 90 patients with endometrial cancer history were involved in a clinical one designed to investigate residual tumors after curettage [57]. The results support that [18F]FDG PET/CT can be used for exact determination of residual tumors in endometrial cancers [57]. Furthermore, it was concluded that in patients with low grade carcinomas and lesion sizes <1.35 cm, [18F]FDG uptake would be low, possibly leading to false negative results [57]. In a notable one with coupled [18F]FES and [18F]FDG PET, it was shown that both approaches are advantageous for the differentiation of malignant and benign uterine tumors [58][59]. It was further demonstrated that the estrogen dependency and the glucose tendency of tumor cells decrease and increase respectively, each correlating with tumor aggression in endometrial carcinomas [59]. Moreover, this observation also highlighted the differences in the [18F]FES and the [18F]FDG accumulation rates, as related to estrogen expression and glucose consumption [59]. Considering these differences, the [18F]FDG–to–[18F]FES ratio may be the most informative index reflecting tumor aggressiveness [59]. Taken together, these findings may assist in developing non-invasive methods for guiding decisions regarding the early detection of and the optimal therapeutic processes for gynecological cancers.

3. Vulvar Cancer

Vulvar cancer is a comparatively rare type of neoplasm accounting for 1–5% of the total cancer types in women, and it is more frequent in older women [60]. Distant metastases are very rare in vulvar cancer while lymph node dissemination is observed in 30% of patients [61]. Sentinel node biopsy (SNB) is a gold standard method for staging vulvar cancer without lymphatic spread, and it is useful in preventing post-surgical morbidity [62]. One pervasive issue, however, is the imaging of metastatic LNs. In a clinical trial carried out by Crivellaro et al., 29 patients (mean age 69 years, range 51–88) with vulvar cancer (clinical apparent stage I-II) underwent a pre-operative [18F]FDG PET/CT scan [63]. The results showed that [18F]FDG PET/CT had low sensitivity and moderate specificity in nodal staging; and, thus, it was not an optimal tool for nodal status assessment. Furthermore, PET/CT may not be cost-effective in detecting the rare event of distant metastases in early stages. Nevertheless, further on larger samples are essential to clarify the exact role of [18F]FDG PET/CT scans for this purpose.
Finally, 99mTc-labeled colloids have been considered for detection of sentinel node (SLN) using planar scintigraphy and, more recently, SPECT or SPECT/CT [64][65][66][67]. There is evidence in vulvar cancer patients that indocyanine green (ICG)-[99mTc]Tc-nanocolloid SPECT/CT can be used for personalized lymphatic mapping, possibly providing detailed information about the number and the anatomical location of SNs for adequate surgical guidance [64][68][69].

4. Vaginal Cancer

Vaginal cancer accounts for approximately 1–2% of gynecological malignancies, among which squamous cell carcinomas and melanoma (less than 4% of vaginal tumors) are the most common [70]. The use of SLN mapping with radiocolloids is beneficial for both diagnosis as well as therapy [71][72]. The most common procedure for detection of LNs is preoperative lymphoscintigraphy using [99mTc]Tc-colloids, following a simultaneous intraoperative blue dye procedure and gamma probe [73]. Clinical trials have shown that, in patients undergoing joint lymphoscintigraphy and blue dye procedures, there was a detection rate of 82% SLN, while just 9% of LNs were detected when using each method separately [74]. In 14 patients with vaginal cancers (including 7 squamous cell carcinomas, 5 vaginal melanomas, 1 adenocarcinoma, and 1 undifferentiated carcinoma), at least one lesion was detectable in 79% of all patients and in each case [74]. Many case reports have also demonstrated that SPECT/CT lymphoscintigraphy is a feasible and an ideal method for pre-operative mapping in vaginal cancer [75][76][77][78][79][80][81][82]. However, false negative cases have also been reported [83][84][85].

References

  1. Parkin, D.M.; Pisani, P.; Ferlay, J. Estimates of the worldwide incidence of eighteen major cancers in 1985. Int. J. Cancer 1993, 54, 594–606.
  2. Gandy, N.; Arshad, M.A.; Park, W.-H.E.; Rockall, A.; Barwick, T.D. FDG-PET imaging in cervical cancer. In Seminars in Nuclear Medicine; WB Saunders: Philadelphia, PA, USA, 2019; Volume 49, pp. 461–470.
  3. Zhang, X.; Zeng, Q.; Cai, W.; Ruan, W. Trends of cervical cancer at global, regional, and national level: Data from the global burden of disease study 2019. BMC Public Health 2021, 21, 1–10.
  4. Hull, R.; Mbele, M.; Makhafola, T.; Hicks, C.; Wang, S.M.; Reis, R.M.; Mehrotra, R.; Mkhize Kwitshana, Z.; Kibiki, G.; Bates, D.O. Cervical cancer in low and middle income countries. Oncol. Lett. 2020, 20, 2058–2074.
  5. Zhang, S.; Xu, H.; Zhang, L.; Qiao, Y. Cervical cancer: Epidemiology, risk factors and screening. Chin. J. Cancer Res. 2020, 32, 720–728.
  6. Herrera, F.G.; Prior, J.O. The role of PET/CT in cervical cancer. Front. Oncol. 2013, 3, 34.
  7. Pawar, A.A.; Patil, D.B.; Patel, S.; Mankad, M.; Dave, P. Role of PET–CT Scan in Gynaeconcology. J. Obstet. Gynecol. India 2016, 66, 339–344.
  8. Wong, T.Z.; Jones, E.L.; Coleman, R.E. Positron emission tomography with 2-deoxy-2-fluoro-D-glucose for evaluating local and distant disease in patients with cervical cancer. Mol. Imaging Biol. 2004, 6, 55–62.
  9. Chou, H.-H.; Chang, T.-C.; Yen, T.-C.; Ng, K.-K.; Hsueh, S.; Ma, S.-Y.; Chang, C.-J.; Huang, H.-J.; Chao, A.; Wu, T.-I.; et al. Low Value of -Fluoro-2-Deoxy-d-Glucose positron emission tomography in primary staging of early-stage cervical cancer before radical hysterectomy. J. Clin. Oncol. 2006, 24, 123–128.
  10. Metser, U.; Golan, O.; Levine, C.D.; Even-Sapir, E. Tumor lesion detection: When is integrated positron emission tomography/computed tomography more accurate than side-by-side interpretation of positron emission tomography and computed tomography? J. Comput. Assist. Tomogr. 2005, 29, 554–559.
  11. Belhocine, T.Z.; Urbain, J.-L.; Yen, T.-C.; Grigsby, P.W. Cervical cancer and nuclear medicine: From bench to bedside. Curr. Res. Cancer ISSN 2007, 1, 123–144.
  12. Fyles, A.; Milosevic, M.; Hedley, D.; Pintilie, M.; Levin, W.; Manchul, L.; Hill, R. Tumor hypoxia has independent predictor impact only in patients with node-negative cervix cancer. J. Clin. Oncol. 2002, 20, 680–687.
  13. Lyng, H.; Sundfør, K.; Tropé, C.; Rofstad, E.K. Disease control of uterine cervical cancer: Relationships to tumor oxygen tension, vascular density, cell density, and frequency of mitosis and apoptosis measured before treatment and during radiotherapy. Clin. Cancer Res. 2000, 6, 1104–1112.
  14. Telarovic, I.; Wenger, R.H.; Pruschy, M. Interfering with tumor hypoxia for radiotherapy optimization. J. Exp. Clin. Cancer Res. 2021, 40, 1–26.
  15. Thomlinson, R.H.; Gray, L.H. The Histological structure of some human lung cancers and the possible implications for radiotherapy. Br. J. Cancer 1955, 9, 539–549.
  16. Lucignani, G. PET imaging with hypoxia tracers: A must in radiation therapy. Eur. J. Pediatr. 2008, 35, 838–842.
  17. Thomlinson, R. Tumour anoxia and the response to radiation. Sci. Basis Med. Annu. Rev. 1965, 87, 74–90.
  18. Huang, Y.-Y. An Overview of PET radiopharmaceuticals in clinical use: Regulatory, quality and pharmacopeia monographs of the United States and Europe. Nucl. Med. Phys. 2019, 35–58.
  19. Barbera, L.; Thomas, G. Management of Early and Locally Advanced Cervical Cancer. In Seminars in Oncology; WB Saunders: Philadelphia, PA, USA, 2009; Volume 36, pp. 155–169.
  20. Sharma, S.K.; Nemieboka, B.; Sala, E.; Lewis, J.S.; Zeglis, B.M. Molecular imaging of ovarian cancer. J. Nucl. Med. 2016, 57, 827–833.
  21. Gupta, D.; Lis, C.G. Role of CA125 in predicting ovarian cancer survival-a review of the epidemiological literature. J. Ovarian Res. 2009, 2, 13–20.
  22. Reyners, A.K.L.; Broekman, K.E.; Glaudemans, A.W.J.M.; Brouwers, A.H.; Arts, H.J.G.; van der Zee, A.G.J.; de Vries, E.G.E.; Jalving, M. Molecular imaging in ovarian cancer. Ann. Oncol. 2016, 27, i23–i29.
  23. Park, T.; Lee, S.; Park, S.; Lee, E.; Pahk, K.; Rhee, S.; Cho, J.; Kim, C.; Eo, J.S.; Choe, J.G.; et al. Value of 18F-FDG PET/CT in the detection of ovarian malignancy. Nucl. Med. Mol. Imaging 2014, 49, 42–51.
  24. Palomar, A.; Nanni, C.; Castellucci, P.; Ambrosini, V.; Montini, G.C.; Allegri, V.; Pettinato, C.; Nahhas, A.; Soriano, Á.; Grassetto, G.; et al. Value of FDG PET/CT in patients with treated ovarian cancer and raised CA125 serum levels. Mol. Imaging Biol. 2011, 14, 123–129.
  25. Peng, N.-J.; Liou, W.-S.; Liu, R.-S.; Hu, C.; Tsay, D.-G.; Liu, C.-B. Early detection of recurrent ovarian cancer in patients with low-level increases in serum CA-125 levels by 2-Fluoro-2-Deoxy-d-Glucose-Positron emission tomography/computed tomography. Cancer Biother. Radiopharm. 2011, 26, 175–181.
  26. Gu, P.; Pan, L.-L.; Wu, S.-Q.; Sun, L.; Huang, G. CA 125, PET alone, PET–CT, CT and MRI in diagnosing recurrent ovarian carcinoma: A systematic review and meta-analysis. Eur. J. Radiol. 2009, 71, 164–174.
  27. Rusu, D.; Carlier, T.; Colombié, M.; Goulon, D.; Fleury, V.; Rousseau, N.; Berton-Rigaud, D.; Jaffre, I.; Kraeber-Bodéré, F.; Campion, L. Clinical and survival impact of FDG PET in patients with suspicion of recurrent ovarian cancer: A 6-year follow-up. Front. Med. 2015, 2, 46.
  28. Caobelli, F.; Young AIMN Working Group; Alongi, P.; Evangelista, L.; Picchio, M.; Saladini, G.; Rensi, M.; Geatti, O.; Castello, A.; Laghai, I.; et al. Predictive value of 18F-FDG PET/CT in restaging patients affected by ovarian carcinoma: A multicentre study. Eur. J. Pediatr. 2015, 43, 404–413.
  29. Chung, H.H.; Kwon, H.W.; Kang, K.W.; Park, N.-H.; Song, Y.-S.; Chung, J.-K.; Kang, S.-B.; Kim, J.W. Prognostic value of preoperative metabolic tumor volume and total lesion glycolysis in patients with epithelial ovarian cancer. Ann. Surg. Oncol. 2011, 19, 1966–1972.
  30. Martoni, A.A.; Fanti, S.; Zamagni, C.; Rosati, M.; De Iaco, P.; Grigioni, A.D.; Castellucci, P.; Quercia, S.; Musto, A.; Maccarini, L.R.; et al. FDG-PET/CT monitoring early identifies advanced ovarian cancer patients who will benefit from prolonged neo-adjuvant chemotherapy. Q. J. Nucl. Med. Mol. Imaging Off. Publ. Ital. Assoc. Nucl. Med. (AIMN) Int. Assoc. Radiopharmacol. (IAR) Sect. Soc. 2010, 55, 81–90.
  31. Boers-Sonderen, M.J.; de Geus-Oei, L.-F.; Desar, I.M.; van der Graaf, W.T.; Oyen, W.J.; Ottevanger, P.B.; van Herpen, C.M. Temsirolimus and pegylated liposomal doxorubicin (PLD) combination therapy in breast, endometrial, and ovarian cancer: Phase Ib results and prediction of clinical outcome with FDG-PET/CT. Target. Oncol. 2014, 9, 339–347.
  32. Chalkidou, A.; Landau, D.; Odell, E.; Cornelius, V.; O’Doherty, M.; Marsden, P. Correlation between Ki-67 immunohistochemistry and 18F-Fluorothymidine uptake in patients with cancer: A systematic review and meta-analysis. Eur. J. Cancer 2012, 48, 3499–3513.
  33. Perumal, M.; Stronach, E.A.; Gabra, H.; Aboagye, E.O. Evaluation of 2-Deoxy-2-Fluoro-D-glucose- and 3′-Deoxy-3′-Fluorothymidine–Positron emission tomography as biomarkers of therapy response in platinum-resistant ovarian cancer. Mol. Imaging Biol. 2012, 14, 753–761.
  34. Jensen, M.M.; Erichsen, K.D.; Björkling, F.; Madsen, J.; Jensen, P.B.; Sehested, M.; Højgaard, L.; Kjær, A. Imaging of treatment response to the combination of carboplatin and paclitaxel in human ovarian cancer xenograft tumors in mice using FDG and FLT PET. PLoS ONE 2013, 8, e85126.
  35. Richard, S.D.; Bencherif, B.; Edwards, R.P.; Elishaev, E.; Krivak, T.C.; Mountz, J.M.; DeLoia, J.A. Noninvasive assessment of cell proliferation in ovarian cancer using 3′deoxy-3-fluorothymidine positron emission tomography/computed tomography imaging. Nucl. Med. Biol. 2011, 38, 485–491.
  36. Zhou, M.; Wang, C.; Hu, S.; Zhang, Y.; Yao, Z.; Li, J.; Guo, W.; Zhang, Y. 18F-FLT PET/CT imaging is not competent for the pretreatment evaluation of metastatic gastric cancer: A comparison with 18F-FDG PET/CT imaging. Nucl. Med. Commun. 2013, 34, 694–700.
  37. Group, E.B.C.T.C. Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: An overview of the randomised trials. Lancet 2005, 365, 1687–1717.
  38. Hasan, J.; Ton, N.; Mullamitha, S.; Clamp, A.; McNeilly, A.; Marshall, E.; Jayson, G.C. Phase II trial of tamoxifen and goserelin in recurrent epithelial ovarian cancer. Br. J. Cancer 2005, 93, 647–651.
  39. Argenta, P.A.; Thomas, S.G.; Judson, P.L.; Downs Jr, L.S.; Geller, M.A.; Carson, L.F.; Jonson, A.L.; Ghebre, R. A phase II study of fulvestrant in the treatment of multiply-recurrent epithelial ovarian cancer. Gynecol. Oncol. 2009, 113, 205–209.
  40. Papadimitriou, C.A.; Markaki, S.; Siapkaras, J.; Vlachos, G.; Efstathiou, E.; Grimani, I.; Hamilos, G.; Zorzou, M.; Dimopoulos, M. Hormonal Therapy with Letrozole for Relapsed Epithelial Ovarian Cancer. Oncology 2004, 66, 112–117.
  41. Wilailak, S.; Linasmita, V.; Srisupundit, S. Phase II study of high-dose megestrol acetate in platinum-refractory epithelial ovarian cancer. Anti-Cancer Drugs 2001, 12, 719–724.
  42. Group, E.B.C.T.C. Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: Patient-level meta-analysis of randomised trials. Lancet 2011, 378, 771–784.
  43. van Kruchten, M.; de Vries, E.G.E.; Brown, M.; de Vries, E.F.J.; Glaudemans, A.W.J.M.; Dierckx, R.A.J.O.; Schröder, C.P.; Hospers, G.A.P. PET imaging of oestrogen receptors in patients with breast cancer. Lancet Oncol. 2013, 14, e465–e475.
  44. Yoshida, Y.; Kurokawa, T.; Tsujikawa, T.; Okazawa, H.; Kotsuji, F. Positron emission tomography in ovarian cancer: 18F-deoxy-glucose and 16α-18F-fluoro-17β-estradiol PET. J. Ovarian Res. 2009, 2, 7–10.
  45. van Kruchten, M.; de Vries, E.; Arts, H.J.; Jager, N.M.; Bongaerts, A.H.; Glaudemans, A.W.; Hollema, H.; de Vries, E.G.; Hospers, G.; Reyners, A.K. Assessment of estrogen receptor expression in epithelial ovarian cancer patients using 16α-18F-Fluoro-17β-Estradiol PET/CT. J. Nucl. Med. 2015, 56, 50–55.
  46. Parkin, D.M.; Bray, F.; Ferlay, J.; Pisani, P. Global cancer statistics, 2002. CA Cancer J. Clin. 2005, 55, 74–108.
  47. Jemal, A.; Siegel, R.; Ward, E. Cervical cancer. CA Cancer J. Clin. 2007, 57, 43–66.
  48. Haltia, U.-M.; Butzow, R.; Leminen, A.; Loukovaara, M. FIGO 1988 versus 2009 staging for endometrial carcinoma: A comparative study on prediction of survival and stage distribution according to histologic subtype. J. Gynecol. Oncol. 2014, 25, 30–35.
  49. Alberini, J.-L.; Edeline, V.; Giraudet, A.L.; Champion, L.; Paulmier, B.; Madar, O.; Poinsignon, A.; Bellet, D.; Pecking, A.P. Single photon emission tomography/computed tomography (SPET/CT) and positron emission tomography/computed tomography (PET/CT) to image cancer. J. Surg. Oncol. 2011, 103, 602–606.
  50. Amit, A.; Schink, J.; Reiss, A.; Lowenstein, L. PET/CT in gynecologic cancer: Present applications and future prospects—a clinician’s perspective. PET Clin. 2010, 5, 391–405.
  51. Kitajima, K.; Murakami, K.; Kaji, Y.; Sakamoto, S.; Sugimura, K. Established, emerging and future applications of FDG-PET/CT in the uterine cancer. Clin. Radiol. 2011, 66, 297–307.
  52. Patel, C.N.; Nazir, S.A.; Khan, Z.; Gleeson, F.V.; Bradley, K.M. 18F-FDG PET/CT of cervical carcinoma. Am. J. Roentgenol. 2011, 196, 1225–1233.
  53. Chang, M.-C.; Chen, J.-H.; Liang, J.-A.; Yang, K.-T.; Cheng, K.-Y.; Kao, C.-H. 18F-FDG PET or PET/CT for detection of metastatic lymph nodes in patients with endometrial cancer: A systematic review and meta-analysis. Eur. J. Radiol. 2012, 81, 3511–3517.
  54. Bollineni, V.R.; Ytre-Hauge, S.; Bollineni-Balabay, O.; Salvesen, H.B.; Haldorsen, I.S. High diagnostic value of 18F-FDG PET/CT in endometrial cancer: Systematic review and meta-analysis of the literature. J. Nucl. Med. 2016, 57, 879–885.
  55. Boonya-Ussadorn, T.; Choi, W.H.; Hyun, J.; Kim, S.H.; Chung, S.K.; Yoo, I.R. 18F-FDG PET/CT findings in endometrial cancer patients: The correlation between SUVmax and clinicopathologic features. J. Med. Assoc. Thail. 2014, 97, 115–122.
  56. Tsuyoshi, H.; Tsujikawa, T.; Yamada, S.; Okazawa, H.; Yoshida, Y. Diagnostic value of FDG PET/MRI for staging in patients with ovarian cancer. EJNMMI Res. 2020, 10, 1–14.
  57. Wu, C.; Chen, R.; Zhou, X.; Xia, Q.; Liu, J. Preoperative evaluation of residual tumor in patients with endometrial carcinoma by using 18F-FDG PET/CT. J. Cancer 2020, 11, 2283–2288.
  58. Tsujikawa, T.; Yoshida, Y.; Mori, T.; Kurokawa, T.; Fujibayashi, Y.; Kotsuji, F.; Okazawa, H. Uterine tumors: Pathophysiologic imaging with 16α- fluoro-17β-estradiol and 18F fluorodeoxyglucose PET—initial experience. Radiology 2008, 248, 599–605.
  59. Tsujikawa, T.; Yoshida, Y.; Kudo, T.; Kiyono, Y.; Kurokawa, T.; Kobayashi, M.; Tsuchida, T.; Fujibayashi, Y.; Kotsuji, F.; Okazawa, H. Functional images reflect aggressiveness of endometrial carcinoma: Estrogen receptor expression combined with 18F-FDG PET. J. Nucl. Med. 2009, 50, 1598–1604.
  60. Canlorbe, G.; Rouzier, R.; Bendifallah, S.; Chéreau, E. Impact of sentinel node technique on the survival in patients with vulvar cancer: Analysis of the surveillance, epidemiology, and end results (SEER) database. Gynecol. Obstet. Fertil. 2012, 40, 647–651.
  61. Burger, M.; Hollema, H.; Emanuels, A.G.; Krans, M.; Pras, E.; Bouma, J. The importance of the groin node status for the survival of T1 and T2 Vulval carcinoma patients. Gynecol. Oncol. 1995, 57, 327–334.
  62. Giammarile, F.; Bozkurt, M.F.; Cibula, D.; Pahisa, J.; Oyen, W.J.; Paredes, P.; Olmos, R.V.; Sicart, S.V. The EANM clinical and technical guidelines for lymphoscintigraphy and sentinel node localization in gynaecological cancers. Eur. J. Pediatr. 2014, 41, 1463–1477.
  63. Crivellaro, C.; Guglielmo, P.; De Ponti, E.; Elisei, F.; Guerra, L.; Magni, S.; La Manna, M.; Di Martino, G.; Landoni, C.; Buda, A. 18F-FDG PET/CT in preoperative staging of vulvar cancer patients: Is it really effective? Medicine 2017, 96, e7943.
  64. Collarino, A.; Donswijk, M.; van Driel, W.J.; Stokkel, M.P.; Olmos, R.A.V. The use of SPECT/CT for anatomical mapping of lymphatic drainage in vulvar cancer: Possible implications for the extent of inguinal lymph node dissection. Eur. J. Nucl. Med. Mol. Imaging 2015, 42, 2064–2071.
  65. Bluemel, C.; Safak, G.; Cramer, A.; Wöckel, A.; Gesierich, A.; Hartmann, E.; Schmid, J.-S.; Kaiser, F.; Buck, A.K.; Herrmann, K. Fusion of freehand SPECT and ultrasound: First experience in preoperative localization of sentinel lymph nodes. Eur. J. Nucl. Med. Mol. Imaging 2016, 43, 2304–2312.
  66. KleinJan, G.H.; Van Werkhoven, E.; Berg, N.S.V.D.; Karakullukcu, M.B.; Zijlmans, H.J.M.A.A.; Van Der Hage, J.A.; Van De Wiel, B.A.; Buckle, T.; Klop, W.M.C.; Horenblas, S.; et al. The best of both worlds: A hybrid approach for optimal pre- and intraoperative identification of sentinel lymph nodes. Eur. J. Nucl. Med. Mol. Imaging 2018, 45, 1915–1925.
  67. Mathéron, H.; Berg, N.V.D.; Brouwer, O.; KleinJan, G.; van Driel, W.J.; Trum, J.; Vegt, E.; Kenter, G.; van Leeuwen, F.; Olmos, R.V. Multimodal surgical guidance towards the sentinel node in vulvar cancer. Gynecol. Oncol. 2013, 131, 720–725.
  68. Dell’Oglio, P.; de Vries, H.M.; Mazzone, E.; KleinJan, G.H.; Donswijk, M.L.; van der Poel, H.G.; Horenblas, S.; van Leeuwen, F.W.; Brouwer, O.R. Hybrid indocyanine green–99mTc-nanocolloid for single-photon emission computed tomography and combined radio-and fluorescence-guided sentinel node biopsy in penile cancer: Results of 740 inguinal basins assessed at a single institution. Eur. Urol. 2020, 78, 865–872.
  69. Bayat, Z.; Saeedzadeh, E.; Vahidfar, N.; Sadeghi, M.; Farzenefar, S.; Daha, F.J.; Salehi, Y. Preparation and validation of Ga-phytate kit and Monte Carlo dosimetry: An effort toward developing an impressive lymphoscintigraphy tracer. J. Radioanal. Nucl. Chem. Artic. 2022, 331, 691–700.
  70. Carter, J.S.; Downs, L.S. Vulvar and Vaginal Cancer. Obstet. Gynecol. Clin. N. Am. 2012, 39, 213–231.
  71. Tinneberg, H.-R.; Zambo, K.; Koppán, M.; Paál, A.; Schmidt, E.; Bódis, J. Sentinel lymph nodes in gynaecological malignancies: Frontline between TNM and clinical staging systems? Eur. J. Nucl. Med. Mol. Imaging 2003, 30, 1684–1688.
  72. Kraft, O.; Havel, M. Detection of sentinel lymph nodes by SPECT/CT and planar scintigraphy: The influence of age, gender and BMI. J. Biomed. Graph. Comput. 2012, 2, 11.
  73. Ayhan, A.; Celik, H.; Dursun, P. Lymphatic mapping and sentinel node biopsy in gynecological cancers: A critical review of the literature. World J. Surg. Oncol. 2008, 6, 53.
  74. Harisankar, C.N.B.; Mittal, B.R.; Bhattacharya, A.; Dhaliwal, L.K. Utility of SPECT/CT in sentinel lymph node detection in a case of vulvar carcinoma. Mol. Imaging Radionucl. Ther. 2013, 22, 106–108.
  75. Rodier, J.; Janser, J.; David, E.; Routiot, T.; Ott, G. Radiopharmaceutical-Guided surgery in primary malignant melanoma of the vagina. Gynecol. Oncol. 1999, 75, 308–309.
  76. Kobayashi, K.; Ramirez, P.T.; Kim, E.E.; Levenback, C.F.; Rohren, E.M.; Frumovitz, M.; Mar, M.V.; Gayed, I.W. Sentinel node mapping in vulvovaginal melanoma using SPECT/CT lymphoscintigraphy. Clin. Nucl. Med. 2009, 34, 859–861.
  77. Abramova, L.; Parekh, J.; Irvin, W.P.; Rice, L.W.; Taylor, P.T.; Anderson, W.A.; Slingluff, C.L. Sentinel node biopsy in vulvar and vaginal melanoma: Presentation of six cases and a literature review. Ann. Surg. Oncol. 2002, 9, 840–846.
  78. Dhar, K.; Das, N.; Brinkman, D.; Beynon, J.; Woolas, R. Utility of sentinel node biopsy in vulvar and vaginal melanoma: Report of two cases and review of the literature. Int. J. Gynecol. Cancer 2007, 17, 720–723.
  79. Nakagawa, S.; Koga, K.; Kugu, K.; Tsutsumi, O.; Taketani, Y. The evaluation of the sentinel node successfully conducted in a case of malignant melanoma of the vagina. Gynecol. Oncol. 2002, 86, 387–389.
  80. Soergel, P.; Hillemanns, P.; Klapdor, R.; Jentschke, M.; Christgen, M.; Hertel, H. Sentinel lymphonodectomy in early vaginal cancer using combined near infrared fluorescence from indocyanine green and technetium-99m nanocolloid–a first case report. Clin. Obstet. Gynecol. Reprod. Med. 2017, 3, 1–3.
  81. Van Dam, P.; Sonnemans, H.; Van Dam, P.-J.; Verkinderen, L.; Dirix, L.Y. Sentinel node detection in patients with vaginal carcinoma. Gynecol. Oncol. 2004, 92, 89–92.
  82. Frumovitz, M.; Gayed, I.W.; Jhingran, A.; Euscher, E.D.; Coleman, R.L.; Ramirez, P.T.; Levenback, C.F. Lymphatic mapping and sentinel lymph node detection in women with vaginal cancer. Gynecol. Oncol. 2008, 108, 478–481.
  83. Boran, N.; Cırık, D.A.; Işıkdoğan, Z.; Kır, K.M.; Turan, T.; Tulunay, G.; Kose, M.F. Sentinel lymph node detection and accuracy in vulvar cancer: Experience of a tertiary center in Turkey. J. Turk. Gynecol. Assoc. 2013, 14, 146–152.
  84. Levenback, C.F.; Ali, S.; Coleman, R.L.; Gold, M.A.; Fowler, J.M.; Judson, P.L.; Bell, M.C.; De Geest, K.; Spirtos, N.M.; Potkul, R.K.; et al. Lymphatic mapping and sentinel lymph node biopsy in women with squamous cell carcinoma of the vulva: A gynecologic oncology group study. J. Clin. Oncol. 2012, 30, 3786–3791.
  85. Kim, J.-H.; Kim, D.-Y.; Suh, D.-S.; Kim, J.-H.; Kim, Y.-M.; Kim, Y.-T.; Nam, J.-H. The efficacy of sentinel lymph node mapping with indocyanine green in cervical cancer. World J. Surg. Oncol. 2018, 16, 1–7.
More
© Text is available under the terms and conditions of the Creative Commons Attribution (CC BY) license; additional terms may apply. By using this site, you agree to the Terms and Conditions and Privacy Policy.
Upload a video for this entry
Information
Subjects: Obstetrics & Gynaecology
Contributors MDPI registered users' name will be linked to their SciProfiles pages. To register with us, please refer to https://encyclopedia.pub/register : Eóin Molloy , ELISABETH EPPARD , Nasim Vahidfra ,
, Hojjat Ahmadzadehfar
View Times: 740
Revisions: 2 times (View History)
Update Date: 22 Apr 2022
Table of Contents
    1000/1000
    Hot Most Recent
    Notice
    You are not a member of the advisory board for this topic. If you want to update advisory board member profile, please contact office@encyclopedia.pub.
    OK
    Confirm
    Only members of the Encyclopedia advisory board for this topic are allowed to note entries. Would you like to become an advisory board member of the Encyclopedia?
    Yes
    No
    Academic Video Service
    Feedback