Abstract
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Objectives: To investigate the sensitivity and specificity of 18F-fluordesoxyglucose positron emission tomography/magnetic resonance (18F-FDG PET/MR) in the detection of lymph node metastases in patients suffering from stage I-II A1 endometrial and cervical cancer.
Methods: Sixteen female patients with stage I-II A1 endometrial and cervical cancer (mean age 50.5 ± 16.0 years) for distant metastasis staging were included in this retrospective study. Patients all underwent integrated 18F-FDG PET/MR scan (GE Signa, GE Healthcare, WI, USA). Integrated PET/MR images were assessed for lymph node metastases by two independent experienced readers. Discrepant results were resolved in a consensus reading by a third senior doctor. Sensitivities, specificities, positive predictive values and negative predictive values were calculated with the gold standard, histopathology.
Results: There were totally 145 lymph nodes detected from the PET/MR images in the study. Compared with histopathology, lymph nodes metastases were true positive in 10 cases, true negative in 132 cases, false positive in no case and false negative in 3 cases in integrated 18F-FDG PET/MR images. And hence, the sensitivity, specificity, positive predictive value and negative predictive value were calculated as follows: 76.9%, 100%, 100% and 97.8%.
Conclusions: Integrated 18F-FDG PET/MR can reliably differentiate N-positive from N-negative in patients with stage I-IIA1 endometrial and cervical cancer, but only a small part of lymph node metastases were still not detected. Hence, Lymph node dissection is also necessary for those patients with stage I-IIA1 endometrial and cervical cancer with no lymph node metastases suggested in PET/MR.
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