Document Detail


Comparison of the validity of magnetic resonance imaging and positron emission tomography/computed tomography in the preoperative evaluation of patients with uterine corpus cancer.
MedLine Citation:
PMID:  18201753     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare positron emission tomography/computed tomography (PET/CT) with magnetic resonance imaging (MRI) in the preoperative detection of primary lesions and lymph node (LN) and distant metastases in patients with uterine corpus cancer. METHODS: The patient cohort consisted of 53 women with uterine corpus cancer who underwent preoperative workup, including both MRI and PET/CT scans, and underwent surgical staging, including pelvic and/or paraaortic LN dissection, between October 2004 and June 2007 at Asan Medical Center, Seoul, Korea. Pathologic data from surgical staging were compared with the preoperative MRI and PET/CT results. For area specific analysis, LNs were divided into paraaortic, right pelvic and left pelvic areas. RESULTS: In detecting primary lesions, MRI and PET/CT showed no differences in sensitivity (91.5% vs. 89.4%), specificity (33.3% vs. 50.5%), accuracy (84.9% vs. 84.9%), positive predictive value (PPV) (91.5% vs. 93.3%) and negative predictive value (NPV) (33.3% vs. 37.5%). With MRI, the sensitivity, specificity, accuracy, PPV and NPV for detecting metastatic LNs on LN area-by-area analysis were 46.2%, 87.9%, 83.9%, 28.6% and 94.0%, respectively; With PET/CT, those were 69.2%, 90.3%, 88.3%, 42.9%, and 96.6%, respectively. PET/CT showed higher sensitivity, but it did not reach statistical significance (p=0.250). There were also no differences in specificity, accuracy, PPV and NPV. In detecting distant metastasis, the sensitivity, specificity, accuracy, PPV and NPV of PET/CT were 100%, 93.8%, 92.5%, 62.5% and 100%, respectively. CONCLUSION: In patients with uterine corpus cancer, PET/CT had moderate sensitivity, specificity and accuracy in detecting primary lesions and LN metastases, indicating that this method cannot replace surgical staging. The primary benefit of PET/CT is its sensitivity in detecting distant metastases. Because of its high NPV in predicting LN metastasis, PET/CT may also have advantages in selected patients who are poor candidates for surgical staging.
Authors:
Jeong-Yeol Park; Eyu Nyong Kim; Dae-Yeon Kim; Dae-Shik Suh; Jong-Hyeok Kim; Yong-Man Kim; Young-Tak Kim; Joo-Hyun Nam
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Publication Detail:
Type:  Comparative Study; Journal Article; Validation Studies     Date:  2008-01-16
Journal Detail:
Title:  Gynecologic oncology     Volume:  108     ISSN:  1095-6859     ISO Abbreviation:  Gynecol. Oncol.     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-02-25     Completed Date:  2008-03-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0365304     Medline TA:  Gynecol Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  486-92     Citation Subset:  IM    
Affiliation:
Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center, #388-1 Poongnap-dong, Songpa-Ku, Seoul, 138-736, South Korea.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Carcinoma, Endometrioid / pathology,  radionuclide imaging,  surgery
Cohort Studies
Cystadenocarcinoma, Serous / pathology,  radionuclide imaging,  surgery
Female
Humans
Korea / epidemiology
Lymph Nodes / pathology
Lymphatic Metastasis
Magnetic Resonance Imaging*
Medical Records
Middle Aged
Neoplasm Staging
Pelvis / pathology
Positron-Emission Tomography*
Predictive Value of Tests
Reproducibility of Results
Retrospective Studies
Sensitivity and Specificity
Tomography, X-Ray Computed
Uterine Neoplasms / pathology*,  radionuclide imaging*,  surgery

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