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Value of imaging study in predicting pelvic lymph node metastases of uterine cervical cancer

Title
Value of imaging study in predicting pelvic lymph node metastases of uterine cervical cancer
Authors
Jung W.Park K.R.Lee K.-J.Lee J.Jeong S.Kim Y.-J.Kim J.Yoon H.-J.Kang B.-C.Koo H.S.Sung S.H.Cho M.-S.Park S.Kim K.
Ewha Authors
김규보박경란구혜수강병철조민선박상희윤혜전
SCOPUS Author ID
구혜수scopus; 강병철scopus; 조민선scopus; 박상희scopus; 윤혜전scopus; 김규보scopus; 박경란scopus
Issue Date
2017
Journal Title
Radiation Oncology Journal
ISSN
2234-1900JCR Link
Citation
vol. 35, no. 4, pp. 340 - 348
Keywords
Computed tomographyLymph nodesMagnetic resonance imagingPositron-emission tomographyUterine cervical neoplasms
Publisher
Department of Radiation Oncology
Indexed
SCOPUS scopus
Abstract
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. © 2017. The Korean Society for Radiation Oncology.
DOI
10.3857/roj.2017.00206
Appears in Collections:
의학전문대학원 > 의학과 > Journal papers
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