Retrocrural Lymph Node Metastasis Disclosed by $^{18}F$-FDG PET/CT: A Predictor of Supra-diaphragmatic Spread in Ovarian Cancer

• Published in: Nuclear medicine and molecular imaging 2012, Vol.46 (1), p.41-47
• Main Authors: Im, Hyung-Jun, Kim, Yong-Il, Paeng, Jin-Chul, Chung, June-Key, Kang, Soon-Beom, Lee, Dong-Soo
• Format: Article
• Language: Korean
• ISSN: 1869-3474; 1869-3482

Purpose : Retrocrural lymph nodes (RCLNs) communicate with retroperitoneal and posterior mediastinal LNs. It is possible that, when RCLNs are involved, supra-diaphragmatic extension will occur in abdomino-pelvic cancers. The authors investigated performance of $^{18}F$-FDG PET/CT to diagnose RCLN metastasis and whether RCLN metastases were associated with supra-diaphragmatic lymphatic metastases of ovarian cancer. Materials and methods : Sixty-seven patients with stage IV ovarian cancer who had undergone $^{18}F$-FDG PET/CT were included in this retrospective study. Diagnostic performance of $^{18}F$-FDG PET/CT for RCLN metastasis was evaluated. Patients were divided into two groups by presence or absence of supra-diaphragmatic LN metastasis. The prevalences of RCLN metastasis between the two groups were compared and the odds ratio was calculated. Results : Sensitivity and specificity of $^{18}F$-FDG PET/CT for RCLN metastasis were 96.3 and 100%, respectively. Of the 67 study subjects, 27 patients had RCLN metastases (40.3%). Fifty patients had supra-diaphragmatic LN metastases. $^{18}F$-FDG PET/CT showed 26 RCLN metastases in patients with supra-diaphragmatic LN metastases (54.5%), and only 1 in patients without supra-diaphragmatic LN metastasis (5.9%), and the difference between two groups was statistically significant (P