Fludeoxyglucose (FDG) F 18 PET Scan, CT Scan, and Ferumoxtran-10 MRI Scan Before Chemotherapy and Radiation Therapy in Finding Lymph Node Metastasis in Patients With Locally Advanced Cervical Cancer or High-Risk Endometrial Cancer

This is an interventional diagnostic trial for Cervical Adenocarcinoma Read More

Inclusion Criteria:

• Histologically or cytologically confirmed diagnosis of 1 of the following:

  • Invasive carcinoma of the cervix meeting all of the following criteria:

    • Previously untreated, primary disease
    • Locoregionally advanced (stage IB2, IIA [>= 4 cm], or IIB-IVA) disease
    • Any cell type allowed

  • High-risk endometrial carcinoma meeting 1 of the following criteria:

    • Grade 3 endometrioid or non-endometrioid endometrial carcinoma (clear cell or serous papillary) or carcinosarcoma diagnosed from an endometrial biopsy or dilation and curettage or
    • Grade 1 or 2 endometrioid endometrial carcinoma with cervical stromal involvement overt on clinical examination or confirmed by endocervical curettage
• Under consideration for chemoradiotherapy (patients with cervical cancer)
• Undergone appropriate surgery for cervical or endometrial carcinoma with appropriate tissue available for histologic evaluation to confirm diagnosis and stage

• Appropriate surgical candidate to undergo extraperitoneal or laparoscopic lymph node sampling OR hysterectomy and lymph node sampling

  • No surgery for patients with advanced lymphadenopathy
• No recurrent invasive carcinoma of the uterus or uterine cervix regardless of previous treatment
• No known metastases to the lungs or scalene lymph nodes

• No metastases to other organs outside of the pelvis or abdominal lymph nodes at the time of the original clinical diagnosis

  • Patients with endometrial cancer with known intraperitoneal disease are eligible provided they undergo pelvic and para-aortic lymphadenectomy per protocol
• Participants must be enrolled at an American College of Radiology Imaging Network (ACRIN)-affiliated institution that is accredited by Gynecologic Oncology Group (GOG)
• GOG performance status 0-2
• Creatinine within normal institutional limits OR, in participants with creatinine levels above institutional normal, glomerular filtration rate (GFR) must be > 60 mL/min; there is no lower limit of normal for serum creatinine for this protocol

• Ferritin levels =< 600 ng/mL OR saturation of transferrin level =< 50%

  • Patients with high levels of ferritin or transferrin are eligible if documented hematology rules out iron overload
• Not pregnant or nursing
• Negative pregnancy test
• No patients weighing greater than that allowable by the PET/CT scanner
• No renal abnormalities, such as a pelvic kidney, horseshoe kidney, or renal transplantation, that would require modification of the lymphadenectomy
• No history of anaphylactic or life-threatening allergic reactions to any contrast media
• No other invasive malignancies within the past 5 years with the exception of nonmelanoma skin cancer
• No contraindication to MRI (e.g., severe claustrophobia, pacemaker, aneurysm clips, defibrillators, or other institutional contraindication to MRI)
• No history of allergic reactions attributed to compounds of similar chemical or biological composition to ferumoxtran-10 (e.g., iron preparations, parenteral iron, parenteral dextran, parenteral iron-dextran, or parenteral iron-polysaccharide preparations)
• No immunodeficiencies that would predispose patient to specific or nonspecific mediator release
• No history of cirrhosis
• No poorly controlled, insulin-dependent diabetes (i.e., fasting blood glucose level > 200 mg/dL)
• No prior pelvic or abdominal lymphadenectomy
• No prior pelvic radiotherapy
• No prior anticancer therapy that would contraindicate study participation
• No ferumoxides within the past 2 weeks
• No investigational agents within the past 30 days
• No other concurrent investigational agents