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KMID : 1038620170350040340
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Radiation Oncology Journal
2017 Volume.35 No. 4 p.340 ~ p.348
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Value of imaging study in predicting pelvic lymph node metastases of uterine cervical cancer
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Jung Won-Guen
Park Kyung-Ran
Lee Kyung-Ja
Kim Kyu-Bo
Lee Ji-Hae
Jeong Song-Mi
Kim Yi-Jun
Kim Ji-Young
Yoon Hai-Jeon
Kang Byung-Chul
Koo Hae-Soo
Sung Sun-Hee
Cho Min-Sun
Park Sang-Hui
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Abstract
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Purpose: To evaluate the diagnostic accuracy of computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography/computed tomography (PET/CT) in predicting pelvic lymph node (LN) metastases in patients with cervical cancer.
Materials and Methods: From January 2009 to March 2015, 114 patients with FIGO stage IA1-IIB uterine cervical cancer who underwent hysterectomy with pelvic lymphadenectomy and took CT, MRI, and PET/CT before surgery were enrolled in this study. The criteria for LN metastases were a LN diameter ≥1.0 cm and/or the presence of central necrosis on CT, a LN diameter ≥1.0 cm on MRI, and a focally increased FDG uptake on PET/CT. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for pelvic LN metastases were estimated.
Results: The sensitivity, specificity, PPV, NPV, and accuracy for detection of pelvic LN metastases were 51.4%, 85.9%, 41.3%, 90.1%, and 80.3% for CT; 24.3%, 96.3%, 56.3%, 86.8%, and 84.6% for MRI; and 48.6%, 89.5%, 47.4%, 90.0%, and 82.9% for PET/CT, respectively. The sensitivity of PET/CT and CT was higher than that of MRI (p=0.004 and p= 0.013, respectively). The specificity of MRI was higher than those of PET/CT and CT (p=0.002 and p=0.001, respectively). The difference of specificity between PET/CT and CT was not statistically significant (p=0.167).
Conclusion: These results indicate that preoperative CT, MRI, and PET/CT showed low to moderate sensitivity and PPV, and moderate to high specificity, NPV, and accuracy. More efforts are necessary to improve sensitivity of imaging modalities in order to predict pelvic LN metastases.
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KEYWORD
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Uterine cervical neoplasms, Lymph nodes, Magnetic resonance imaging, Computed tomography, Positron-emission tomography
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