Abstract
Objective.
To compare positron emission tomography/computed tomography (PET/CT) with magnetic
resonance imaging (MRI) in the preoperative detection of primary lesions and lymph
node (LN) and distant metastases in patients with uterine corpus cancer.
Methods.
The patient cohort consisted of 53 women with uterine corpus cancer who underwent
preoperative workup, including both MRI and PET/CT scans, and underwent surgical staging,
including pelvic and/or paraaortic LN dissection, between October 2004 and June 2007
at Asan Medical Center, Seoul, Korea. Pathologic data from surgical staging were compared
with the preoperative MRI and PET/CT results. For area specific analysis, LNs were
divided into paraaortic, right pelvic and left pelvic areas.
Results.
In detecting primary lesions, MRI and PET/CT showed no differences in sensitivity
(91.5% vs. 89.4%), specificity (33.3% vs. 50.5%), accuracy (84.9% vs. 84.9%), positive
predictive value (PPV) (91.5% vs. 93.3%) and negative predictive value (NPV) (33.3%
vs. 37.5%). With MRI, the sensitivity, specificity, accuracy, PPV and NPV for detecting
metastatic LNs on LN area-by-area analysis were 46.2%, 87.9%, 83.9%, 28.6% and 94.0%,
respectively; With PET/CT, those were 69.2%, 90.3%, 88.3%, 42.9%, and 96.6%, respectively.
PET/CT showed higher sensitivity, but it did not reach statistical significance (p=0.250). There were also no differences in specificity, accuracy, PPV and NPV. In detecting
distant metastasis, the sensitivity, specificity, accuracy, PPV and NPV of PET/CT
were 100%, 93.8%, 92.5%, 62.5% and 100%, respectively.
Conclusion.
In patients with uterine corpus cancer, PET/CT had moderate sensitivity, specificity
and accuracy in detecting primary lesions and LN metastases, indicating that this
method cannot replace surgical staging. The primary benefit of PET/CT is its sensitivity
in detecting distant metastases. Because of its high NPV in predicting LN metastasis,
PET/CT may also have advantages in selected patients who are poor candidates for surgical
staging.
Keywords
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Article info
Publication history
Received:
October 11,
2007
Identification
Copyright
© 2007 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
