The role of positron emission tomography (PET) in the evaluation of groin nodes associated with early invasive vulval cancer: A pilot study

The ability of Positron Emission Tomography (PET) scanning using the radiotracer 18-Fluoro-2-deoxyglucose (FDG) to predict the groin node status in women with early invasive: (Stage I and II) vulval squamous cell carcinoma was evaluated. Ten patients were tested and also 2 with cytology proven positive groin nodes from recurrent cervical cancer and Stage II Bartholi’s cancer. PET scanning of both groins were done within one week prior to undergoing radical vulvectomy and bilateral groin dissection. A single blinded independent observer reviewed the scans. The FDG activity was assessed and the results compared with the histological fndings. Histological and PET evaluation of the 20 groins in the women with early invasive vulval cancer found no evidence of metastatic disease. Benign reactive changes were identified in 3 groins. The groin status of the other 2 patients with biopsy proven positive groin nodes was also correctly determined. This pilot study found PET to be a safe and well tolerated minimally invasive diagnostic procedure. Its ability to reliably predict metastatic nodal disease in this setting based solely on FDG activity and not on morphology or size is encouraging. A larger patient accrual is now required to verify this technique.