Comparison of Dynamic Helical CT and Dynamic MR Imaging in the Evaluation of Pelvic Lymph Nodes in Cervical Carcinoma

Abstract

Helical CT and MR imaging show similar accuracy in the evaluation of pelvic lymph nodes in patients with cervical carcinoma. Central necrosis is useful in the diagnosis of metastasis in pelvic lymph nodes in cervical cancer.

Imaging in cervical cancer

“…40 Subak et al 35 reviewed studies comparing the accuracy of CT and MRI in the preoperative evaluation of parametrial invasion, disease stage, and lymph node involvement. Yang et al 36 compared helical CT and dynamic MRI, evaluating their sensitivity (64.7% vs. 70.6%), specificity (96.6% vs. 89.9%), positive predictive value (84.6% vs. 66.7%), negative predictive value (90.5% vs. 91.4%), and accuracy (89.5% vs. 85.5%).…”

“…The overall accuracy rates of MRI and CT in determining lymph node metastasis status in patients with cervical carcinoma range from 85% to 90%. 36 Exciting advances in novel combinations of contrast agents and techniques, such as iron oxide-enhanced MRI lymphography, may allow internal structure to be seen in normal-sized lymph nodes. These advances may make MRI as sensitive and specific as conventional lymphangiography.…”

Feasibility of diffusion‐weighted imaging in the differentiation of metastatic from nonmetastatic lymph nodes: Early experience

“…Regarding the diagnostic performance of MR imaging for detecting metastatic lymph nodes in patients with uterine cervical cancer, previous studies have shown a variable sensitivity ranging from 24 % to 72% (3)(4)(5)(6). According to a recent study which strictly applied lesion-by-lesion analysis, the sensitivity of MR was poor at only 30% (7).…”

Evaluation of cervical cancer by computed tomography: Current status

“…3,5,6 Pelvic lymph nodes may be enlarged because of metastases or secondary infection, and the two entities cannot be distinguished on CT. 7,8 There is overlap in the size and enhancement of malignant and hyperplastic lymph nodes. 9 However, if the lymph node is necrotic, then the positive predictive value for malignancy is 100%. 9 Having a lymph node of normal size does not exclude the possibility of the presence of microscopic tumor.…”

“…9 However, if the lymph node is necrotic, then the positive predictive value for malignancy is 100%. 9 Having a lymph node of normal size does not exclude the possibility of the presence of microscopic tumor. 3 However, a meta-analysis of the literature on the utility of CT in identifying malignant lymph nodes showed that the presence of lymph nodes of normal size reduces the probability of metastases.…”