Metastases to pelvic lymph nodes from carcinoma in the pelvic cavity: diagnosis using thin-section CT.
OBJECTIVE
To assess the accuracy of thin-section computed tomography (CT) in the diagnosis of pelvic lymph nodes affected by metastatic cancer.


METHODS
Incremental CT was performed by obtaining 3 mm sections with 3 mm intervals in 34 patients who had carcinoma in the pelvis, pre-operatively and prospectively. CT diagnoses were made before surgery using the cine mode with a manual trackball. Lymph nodes with a maximum short axis diameter of greater than 5 mm were considered enlarged.


RESULTS
The accuracy, sensitivity, specificity, positive and negative predictive values of CT diagnoses were 79.7%, 54.5%, 84.9%, 42.9% and 90.0% on a hemipelvis basis; and 79.4%, 85.7%, 77.8%, 50.0% and 95.5% on a patient basis, respectively. There was only one false-negative case on a patient basis analysis.


CONCLUSIONS
Because of a fairly high negative predictive value, negative thin-section CT can be considered an alternative to surgical lymphadenectomy. This is clinically important as unnecessary staging operations and extended surgery are avoided.
Fukuda
H
H
Department of Radiology, School of Medicine, Tokyo Medical and Dental University, Japan.
Nakagawa
T
T
Shibuya
H
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010386:Pelvic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed