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2017 ; 6
(5
): 833-838
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The role of PET/CT imaging in penile cancer
#MMPMID29184780
Ottenhof SR
; Vegt E
Transl Androl Urol
2017[Oct]; 6
(5
): 833-838
PMID29184780
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Positron emission tomography (PET) imaging with (18)F-fluorodeoxyglucose (FDG)
combined with computed tomography (CT) provides functional imaging combined with
anatomic information, improving diagnostic accuracy and confidence. Although
virtually all primary penile tumors are FDG-avid, PET/CT is not recommended for
primary tumor staging as it has limited spatial resolution and is hampered by
urinary FDG excretion. The accuracy of PET/CT for lymph node staging seems to
improve with the pretest likelihood of metastatic nodes. In groins with normal
physical examination, sensitivity is only 57%. In groins with palpably enlarged
lymph nodes, sensitivity of PET/CT reaches 96%. For pelvic lymph nodes and
distant metastases, PET/CT is more accurate if inguinal metastases are present.
However, these results are based on a very limited number of studies. Overall,
the role of PET/CT imaging in penile cancer remains ambiguous, especially in
inguinal lymph nodes. During staging and follow-up, it may be particularly useful
in detecting pelvic lymph node metastases and occult distant metastases prior to
systemic chemotherapy and/or extensive surgery, improving selection of patients
that are most likely to benefit from such therapies.