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Diagnostic Applications of Nuclear Medicine: Penile Cancer

Nuclear Oncology

  • 124 Accesses

Abstract

Penile carcinomas are rare in most developed countries; in contrast, this cancer is not infrequent in the tropical and subtropical regions of Latin America, Asia, and Africa. In addition, penile cancer is common in regions with high prevalence of human papilloma virus infection. More than 95% of penile carcinomas are of the squamous cell type; other histologic types include basal cell carcinoma, melanoma, and sarcoma. Penile carcinoma usually spreads through lymphatic channels to the superficial and deep inguinal lymph nodes; subsequently iliac lymph nodes are involved. The presence and extent of metastatic disease in inguinal nodes is the single most important prognostic factor in patients with penile cancer. Primary evaluation of penile cancer is based on physical examination including inguinal lymph node palpation. Ultrasound and MRI can provide information on tumor invasion of the corpora cavernosa if organ preservation is planned. Ultrasound can be used to evaluate nonpalpable inguinal lymph nodes, whereas pelvic CT scan can be used to assess pelvic lymph nodes. Lymphoscintigraphy, preferably with SPECT/CT imaging, and subsequently sentinel lymph node biopsy is gaining popularity in clinical practice, especially in patients with nonpalpable lymph nodes; sensitivity reported for this local staging approach ranges from 70% to 86%. Assessment of distant metastases should be performed in patients with positive inguinal nodes; this includes abdomen and pelvis CT, chest X-ray, or thoracic CT. [18F]FDG PET/CT can be used for initial staging of penile cancer with pooled sensitivity and specificity of 80.9% and 92.4% respectively; this staging technique is particularly advocated for patients with positive lymph nodes. [18F]FDG PET/CT can also be employed to monitor the efficacy of induction chemotherapy. Follow-up of penile cancer is based mainly on clinical evaluation, while radionuclide imaging techniques have rarely been used for restaging purposes during regular follow-up.

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Abbreviations

[18F]FDG:

2-Deoxy-2-[18F]fluoro-d-glucose

AIDS:

Acquired immune deficiency syndrome

AJCC:

American Joint Committee on Cancer

CDKN2A:

Gene encoding for cyclin dependent kinase inhibitor 2A, also encoding for proteins p16INK4A and p14ARF

CI:

Confidence interval

CpG:

5′-C-phosphate-G-3′ sequence in DNA, where cytosine and guanine are separated by only one phosphate

CT:

X-ray computed tomography

EAU:

European Association of Urology

HPV:

Human papilloma virus

KAI1/CD82:

Member of the tetraspanin family classified as metastasis suppressor gene

LOH:

Loss of heterozygosity

MR:

Magnetic resonance

MRI:

Magnetic resonance imaging

p53:

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

PUVA:

Therapy with psoralen plus ultraviolet light to treat atopic dermatitis

Rb:

Gene encoding for the retinoblastoma protein

SCC Ag:

Squamous cell carcinoma antigen

SCC:

Squamous cell carcinoma

SLN:

Sentinel lymph node

SLNB:

Sentinel lymph node biopsy

SPECT:

Single-photon emission computed tomography

SPECT/CT:

Single-photon emission computed tomography/computed tomography

TNM:

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

US:

Ultrasonography

WHO:

World Health Organization

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Authors and Affiliations

  1. Regional Center of Nuclear Medicine, University of Pisa Medical School, Via Roma 55, 56126, Pisa, Italy

    Serena Chiacchio

  2. Department of Radiology and Nuclear Medicine, University of Jordan, Amman, Jordan

    Abedallatif AlSharif

  3. Institute of Nuclear Medicine, University College London Hospitals, NHS Foundation Trust, University College Hospital, London, UK

    Zia Saad & Jamshed Bomanji

  4. Department of Radiology and Nuclear Medicine, Stadtspital Triemli, Zurich, Switzerland

    Giampiero Giovacchini

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  1. Serena Chiacchio
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  2. Abedallatif AlSharif
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  3. Zia Saad
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  4. Giampiero Giovacchini
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  5. Jamshed Bomanji
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Correspondence to Serena Chiacchio .

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Editors and Affiliations

  1. Attending Emeritus, Memorial Sloan-Kettering Cancer Center Dept. Radiology, New York, New York, USA

    H. William Strauss

  2. Professor Emeritus, University of Pisa, Pisa, Italy

    Giuliano Mariani

  3. Associate Professor and Director of Nuclear Medicine, University of Pisa, Pisa, Italy

    Duccio Volterrani

  4. Attending Physician, Memorial Sloan-Kettering Cancer Center, New York, New York, USA

    Steven M. Larson

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Chiacchio, S., AlSharif, A., Saad, Z., Giovacchini, G., Bomanji, J. (2016). Diagnostic Applications of Nuclear Medicine: Penile Cancer. In: Strauss, H., Mariani, G., Volterrani, D., Larson, S. (eds) Nuclear Oncology. Springer, Cham. https://doi.org/10.1007/978-3-319-26067-9_44-1

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  • DOI: https://doi.org/10.1007/978-3-319-26067-9_44-1

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  1. Latest

    Diagnostic Applications of Nuclear Medicine: Penile Cancer
    Published:
    03 August 2022

    DOI: https://doi.org/10.1007/978-3-319-26067-9_44-2

  2. Original

    Diagnostic Applications of Nuclear Medicine: Penile Cancer
    Published:
    27 September 2016

    DOI: https://doi.org/10.1007/978-3-319-26067-9_44-1

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