SPECT-MRI fusion reduces false positives and risky surgeries for patients with cervical cancer

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Patients with cervical cancer who do not have enlarged nodes may benefit from SPECT-MRI fusion imaging, according to results of a recent study published in the April issue of the  Journal of Nuclear Medicine.

More than half a million new cases of cervical cancer are diagnosed worldwide each year, affecting nearly 19 in every 100,000 American women.

An invasive procedure is the traditional way to investigate whether cervical cancer has spread to the lymph nodes, but many patients could be spared surgery thanks to recent advances in combined SPECT-MRI, said corresponding author Jacob Hoogendam, MD, and his colleagues from University Medical Center Utrecht in the Netherlands.

"An interesting aspect of this research, and the field in general, is that we are taking more and more steps toward combined technology to minimize invasive diagnostics in patients with cervical cancer," he said. "With these methods we aim to reduce morbidity via more tailored and informed selections between radical hysterectomy and chemo/radiation for each patient, instead of solely stage-based treatment selections."

Hoogendam and his team evaluated cervical cancer patients at their facility between March 2011 and February 2015 using fused datasets from both MRI and SPECT-CT imaging results, including mapping of the sentinel lymph nodes, which were then retrospectively reviewed and scored by an experienced radiologist.

Their results show that in 75 cases, 136 sentinel lymph nodes were eligible for analysis, with 13 containing metastases (10 percent).

"This sentinel node focus requires a combination of preoperative nuclear medicine imaging (SPECT), radiology (MRI), and the gynecological oncology department (intraoperative sentinel node procedure),” Hoogendam said. “We should not be islands within a hospital; better interdisciplinary cooperation can synergistically lead to new insights, more relevant research questions, and better patient care."