Accuracy of ¹⁸F-FDG PET/CT in Detecting Pelvic and Paraaortic Lymph Node Metastasis in Patients with Endometrial Cancer

Abstract

Integrated FDG PET/CT is superior to conventional imaging techniques, but it is only moderately sensitive in predicting lymph node metastasis preoperatively in patients with endometrial cancer. Even PET/CT should not replace lymphadenectomy.

Preoperative Positron-Emision Tomography/Computed Tomography Findings in Endometrial Cancer: A Study of 30 Cases

“…It is important to know or predict the stage of disease before the operation to perform full staging surgery. In previous studies, it was found that PET/CT has moderate sensitivity and high specificity for detecting nodal metastasis (29)(30)(31) and high sensitivity and specificy for detecting metastatic disease (32). Authors concluded that PET/CT is not a substitute for lymphadenectomy.…”

Comparison of DWI and PET/CT in evaluation of lymph node metastasis in uterine cancer

“…Conversely, LNs with no detectable tracer uptake were deemed negative for metastatic spread, even if their short-axis diameter was larger than 1 cm. Semiquantitative analysis to determine a standardized value for FDG uptake in the nodal lesions was not performed in our series, in line with the PET/CT image analysis method of several other studies [26][27][28][29][30][31] .…”

“…There have been several reports demonstrating the accuracy of FDG-PET/CT for detecting LN metastasis in uterine cancer [20,[26][27][28][29][30][31] . They revealed the sensitivity, specificity, and accuracy of PET/CT on region-specific analyses were 36%-72%, 88%-99% and 84%-99%, respectively, and that corresponding values for patient-based analyses were 41%-77%, 56%-100% and 76%-89%.…”

“…These modalities include diffusion-weighted imaging (DWI) of MRI, MRI with ultrasmall superparamagnetic iron oxide (USPIO) [13,21,22] , and positron emission tomography and CT (PET/CT) using 18 F-fluorodeoxyglucose (FDG). To date, there have been three reports on apparent diffusion coefficient (ADC) obtained with DWI for the detection of LN metastasis [23][24][25] and several on PET/CT [20,[26][27][28][29][30][31] for uterine cancer. To the best of our knowledge, there have been no studies comparing the diagnostic accuracy of DWI and PET/CT for preoperative evaluation of LNs in patients with uterine cancer.…”

“…May 28, 2012|Volume 4|Issue 5| WJR|www.wjgnet.com not been performed in many studies [26][27][28] . FDG-PET/CT is primarily limited by its inability to detect microscopic metastasis.…”