Mirror-image lymph node in FDG PET/CT and SPECT/CT for sentinel node detection

Clin Nucl Med. 2014 Mar;39(3):e241-2. doi: 10.1097/RLU.0000000000000227.

Abstract

We report a case of a patient with presumed stage IB1 squamous cell carcinoma of the cervix in which FDG PET/CT scan revealed 1 hypermetabolic left iliac node suggestive to be malignant. Lymphoscintigraphy and SPECT/CT studies previous to sentinel node (SLN) biopsy revealed unilateral drainage in the right pelvis. Intraoperative pathological assessment of the SLN showed no tumoral involvement, and the hypermetabolic node revealed macrometastasis. Tumor node invasion can lead to a lymphatic blockage and become false-negative for SLN technique. Although FDG PET/CT has lower sensitivity than surgical staging, this case shows its value as a preoperative imaging technique.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Lymph Nodes / diagnostic imaging*
  • Lymph Nodes / pathology
  • Magnetic Resonance Imaging
  • Multimodal Imaging
  • Positron-Emission Tomography*
  • Sentinel Lymph Node Biopsy*
  • Tomography, Emission-Computed, Single-Photon*
  • Tomography, X-Ray Computed*

Substances

  • Fluorodeoxyglucose F18