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LNs were analysed by two qualitative methods assessing PET information (defined as <jats:italic>visual assessment<\/jats:italic>) and a combination of PET and low-dose CT information (defined as <jats:italic>overall assessment<\/jats:italic>), respectively, as well as semi-quantitative analysis (LN-SUV<jats:sub>max<\/jats:sub>). Sensitivity, specificity, accuracy, positive and negative predictive values (PPV and NPV) in predicting the groin and pelvic LN status were calculated in the overall study population; a subset analysis of groin parameters in clinically\/ultrasonography negative patients was also performed. Histopathology was the reference standard.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>All patients underwent vulvar and inguinofemoral LN surgery, and 35 pelvic LN surgery. Overall, 338 LN sites (296 groins and 42 pelvic sites) were histologically examined with 30.4% prevalence of metastatic groins and 28.6% for metastatic pelvic sites. In the overall study population, sensitivity (95% confidence interval, CI), specificity (95% CI), accuracy (95% CI), PPV (95% CI) and NPV (95% CI) at the groin level were 85.6% (78.3\u201392.8), 65.5% (59.0\u201372.0), 71.6% (66.5\u201376.8), 52.0% (44.0\u201360.1) and 91.2% (86.7\u201395.8) for <jats:italic>visual assessment<\/jats:italic>; 78.9% (70.5\u201387.3), 78.2% (72.5\u201383.8), 78.4% (73.7\u201383.1), 61.2% (52.3\u201370.1) and 89.4% (85.0\u201393.9) for <jats:italic>overall assessment<\/jats:italic>; and 73.3% (64.2\u201382.5), 85.0% (80.1\u201389.8), 81.4% (77.0\u201385.8), 68.0% (58.8\u201377.3) and 87.9% (83.4\u201392.5) for semi-quantitative analysis (SUV<jats:sub>max<\/jats:sub> cut-off value 1.89 achieved by ROC analysis). Similar results were observed in the pelvis-based analysis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>In this large single-centre series of vulvar cancer patients, [<jats:sup>18<\/jats:sup>F]FDG-PET\/CT showed good values of sensitivity and NPV in discriminating metastatic from non-metastatic LNs. In routine clinical practice, qualitative analysis is a reliable interpretative criterion making unnecessary commonly used semi-quantitative methods such as SUV<jats:sub>max<\/jats:sub>.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00259-021-05257-8","type":"journal-article","created":{"date-parts":[[2021,2,23]],"date-time":"2021-02-23T05:42:23Z","timestamp":1614058943000},"page":"3303-3314","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Diagnostic performance of preoperative [18F]FDG-PET\/CT for lymph node staging in vulvar cancer: a large single-centre study"],"prefix":"10.1007","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1045-0633","authenticated-orcid":false,"given":"Vittoria","family":"Rufini","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgia","family":"Garganese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco P.","family":"Ieria","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina","family":"Pasciuto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona M.","family":"Fragomeni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedetta","family":"Gui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita","family":"Florit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frediano","family":"Inzani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gian Franco","family":"Zannoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Scambia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Giordano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Collarino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,2,23]]},"reference":[{"key":"5257_CR1","unstructured":"National Cancer Institute. 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