Cervical cancer is the fourth most common cancer in women worldwide and early diagnosis is critical. A new study published in The Journal of Nuclear Medicine found that cervical cancer patients without enlarged lymph nodes may benefit from SPECT/MR imaging of their sentinel lymph nodes (SLNs) to determine if metastases are present.

Surgical removal and examination of the SLNs is currently the most accurate way to determine if the cancer has spread to the lymph nodes, but SPECT/MR imaging may help to reduce false negative MR findings in early-stage patients, and perhaps prevent some patients from having to undergo the invasive procedure.

"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,” Dr. Jacob P. Hoogendam, the corresponding author of the study, said in a statement.
Researchers from the University Medical Center Utrecht in the Netherlands used Tc-99m-nanocolloid SPECT/MR imaging to assess SLNs in patients with early-stage cervical cancer from March 2011 to February 2015. Patients with enlarged lymph nodes on MR were excluded.

The patients underwent an SLN mapping procedure with preoperative Tc-99m-nanocolloid SPECT/CT imaging. By generating fused data sets of the SPECT and MR, the researchers could identify SLNs on MR with accurate correlation to the histological result of each individual SLN.

An experienced radiologist then reviewed all of the fused SPECT/MR images and scored the morphologic SLN parameters on a standard case report form. They found that in 75 cases, 136 SLNs were eligible for analysis, of which 13 contained metastases.

“Our study investigated whether a more individualized, imaging-based assessment is possible for the small metastases that are currently missed on imaging (i.e., false negative on MRI)," said Hoogendam. “This new imaging approach is a first step, and we hope it sparks further research.” 

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