Andersen et al [26] prospectively evaluated 27 patients with vulvar cancer (23 primary and 4 recurrent) who underwent contrast-enhanced CT scan of the chest, abdomen, and pelvis prior to treatment. IFLN metastases were diagnosed if short-axis diameter was >10 mm and/or abnormal pattern of contrast enhancement were observed. CT had sensitivity of 60%, specificity of 90%, PPV of 37.5%, and NPV of 95.7% for detection of IFLN metastases. CT did not reveal distant metastases from vulvar cancer or alter original treatment plan in any patients. Incidental synchronous cancers were detected in two patients. CT Chest, Abdomen, and Pelvis Contrast-enhanced CT of the chest, abdomen, and pelvis is usually appropriate in patients with suspected vulvar cancer recurrence. Andersen et al [26] prospectively evaluated 27 patients with vulvar cancer (23 primary and 4 recurrent) who underwent contrast-enhanced CT scan of the chest, abdomen, and pelvis prior to treatment. IFLN metastases were diagnosed if short-axis diameter was >10 mm and/or abnormal pattern of contrast enhancement were observed. CT had sensitivity of 60%, specificity of 90%, PPV of 37.5%, and NPV of 95.7% for detection of IFLN metastases. CT Pelvis Contrast-enhanced CT of the pelvis may be considered in patients with suspected vulvar cancer recurrence. However, contrast-enhanced CT of chest, abdomen, and pelvis or FDG-PET/CT is preferred in this group. FDG-PET/CT Skull Base to Mid-Thigh FDG-PET/CT is usually appropriate in patients with suspected vulvar cancer recurrence. FDG-PET/CT, alone or in combination with MRI, can facilitate treatment planning prior to pelvic exenteration for recurrent gynecologic cancers.
Staging and Follow up of Vulvar Cancer. Andersen et al [26] prospectively evaluated 27 patients with vulvar cancer (23 primary and 4 recurrent) who underwent contrast-enhanced CT scan of the chest, abdomen, and pelvis prior to treatment. IFLN metastases were diagnosed if short-axis diameter was >10 mm and/or abnormal pattern of contrast enhancement were observed. CT had sensitivity of 60%, specificity of 90%, PPV of 37.5%, and NPV of 95.7% for detection of IFLN metastases. CT did not reveal distant metastases from vulvar cancer or alter original treatment plan in any patients. Incidental synchronous cancers were detected in two patients. CT Chest, Abdomen, and Pelvis Contrast-enhanced CT of the chest, abdomen, and pelvis is usually appropriate in patients with suspected vulvar cancer recurrence. Andersen et al [26] prospectively evaluated 27 patients with vulvar cancer (23 primary and 4 recurrent) who underwent contrast-enhanced CT scan of the chest, abdomen, and pelvis prior to treatment. IFLN metastases were diagnosed if short-axis diameter was >10 mm and/or abnormal pattern of contrast enhancement were observed. CT had sensitivity of 60%, specificity of 90%, PPV of 37.5%, and NPV of 95.7% for detection of IFLN metastases. CT Pelvis Contrast-enhanced CT of the pelvis may be considered in patients with suspected vulvar cancer recurrence. However, contrast-enhanced CT of chest, abdomen, and pelvis or FDG-PET/CT is preferred in this group. FDG-PET/CT Skull Base to Mid-Thigh FDG-PET/CT is usually appropriate in patients with suspected vulvar cancer recurrence. FDG-PET/CT, alone or in combination with MRI, can facilitate treatment planning prior to pelvic exenteration for recurrent gynecologic cancers.