High false-positive rate of fluorodeoxyglucose positron emission tomography to detect lymph node metastasis in microinvasive cervical cancer after conization

We aimed to estimate the positive predictive value of fluorodeoxyglucose positron emission tomography (FDG PET) to detect lymph node metastasis in patients with microinvasive cervical cancer who recently underwent conization. We retrospectively collected data of patients fulfilling the following criteria: 1) cervical cancer stage 1A1 (by FIGO staging revised in 1994) without invasion of the lymphovascular space diagnosed by conization from September 2008 to July 2018, 2) FDG PET within 3 months after diagnosis, 3) lymph node metastasis suspected by FDG PET, and 4) histologic confirmation or follow-up imaging study for suspected lymph node metastasis. Lymph node metastasis was suspected in 31 regions in 18 patients; however, no true metastasis was found. In conclusion, lymph node metastasis suspected by FDG PET in microinvasive cervical cancer after conization might be false positive. Lymph node dissection should not be performed for such patients.