Diagnostic Applications of Nuclear Medicine: Vulvar Cancer

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Abstract

Vulvar cancer is an uncommon malignancy in females and is less frequently seen as compared to cervical or endometrial cancer. Human papillomavirus (HPV) infection, chronic lichen simplex infection, and genital warts are considered some of the predisposing factors. While metastases occur in late-stage disease (usually via lymphatic spread), many lesions are seen in the early stages. Anatomic imaging is the mainstay of evaluation for local extent. [18F]FDG PET imaging has incremental value for evaluation of equivocal lesions, assessing nodal status and detecting distant metastasis. Lymphoscintigraphy for sentinel node mapping is useful for surgical planning and limiting postoperative morbidity from extensive nodal dissection. This review summarizes the current status and emerging trends in imaging vulvar cancer using radiopharmaceuticals.

Keywords

Vulvar cancer Vulvar cancer imaging [18F]FDG PET/CT in vulvar cancer Lymphoscintigraphy Sentinel node mapping 

Glossary

[18F]FDG

2-deoxy-2-[18F]fluoro-D-glucose

AJCC

American Joint Committee on Cancer

CT

X-ray computed tomography

FIGO

International Federation of Gynecology and Obstetrics

GOG

Gynecologic Oncology Group

GROINSS V

GROningen INternational Study on Sentinel Lymph Nodes in Vulvar Cancer

HPE

Histopathology exam

HPV

Human papillomavirus

ICG

Indocyanine green

ILN

Inguinal lymph nodes

LN

Lymph node

LSG

Lymphoscintigraphy

M

Metastasis status according to the AJCC/UICC TNM staging system

MIP

Maximum intensity projection

MRI

Magnetic resonance imaging

N

Lymph node status according to the AJCC/UICC TNM staging system

NA

Not available

NCCN

National Comprehensive Cancer Network

NIRF

Near-infrared fluorescent imaging

NPV

Negative predictive value

OS

Overall survival

p16

Gene encoding the cyclin-dependent kinase inhibitor 2A, also known as multiple tumor suppressor 1

p53

Gene encoding for tumor protein p53, also known as cellular tumor antigen p53, phosphoprotein p53, tumor suppressor p53, antigen NY-CO-13, or transformation-related protein 53 (TRP53)

PET

Positron emission tomography

PET/CT

Positron emission tomography/Computed tomography

PPV

Positive predictive value

SCC

Squamous cell carcinoma

SLN

Sentinel lymph node

SN

Sensitivity

SPECT

Single-photon emission computed tomography

SPECT/CT

Single-photon emission computed tomography/Computed tomography

SUV

Standardized uptake value

SUVmax

Standardized uptake value at point of maximum

T

Tumor status according to the AJCC/UICC TNM staging system

TNM

AJCC/UICC staging system based on parameters “T” (tumor status), “N” (lymph node status), and “M” (distant metastasis status)

UICC

Union Internationale Contre le Cancer (International Union Against Cancer)

US

Ultrasound

VIN

Vulvar intraepithelial neoplasia

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Copyright information

© Springer International Publishing AG 2016

Authors and Affiliations

  • Sonia Mahajan
    • 1
  • Weining Ma
    • 1
  • Neeta Pandit-Taskar
    • 1
  1. 1.Memorial Sloan Kettering Cancer CenterNew YorkUSA

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