Selective pretreatment diagnostic imaging for detecting remote metastases in patients with endometrial cancer.
OBJECTIVE
Various diagnostic tests are available to rule out metastases. However, not all of these tests provide significant information. Based on data collected at our institution, we have analyzed the significance of various imaging methods.


METHODS
In 337 patients with fully staged endometrial carcinoma, the results of chest X-rays, bone scintigraphy, computed tomography (CT), magnetic resonance imaging (MRI) and ultrasonography of the liver, kidneys and abdomen were analyzed.


RESULTS
In the 7 patients who showed metastases, the liver was the most frequently affected organ. Hepatic CT is associated with a likelihood ratio (LR) of 9.0, hence representing a valuable technique. In cases with a pretest probability of 1.19% (independent of the disease stage), CT results in a post-test probability of 9.78%, putting into question the usefulness of the method for confirming metastases. With all other analyzed diagnostic modalities, even less information is gained.


CONCLUSIONS
The routine use of the above diagnostic methods, indiscriminate of the disease stage, is not justified. LRs provide an estimate of the information gained by a diagnostic procedure.
Heyer
Hans
H
Department of Gynecology and Obstetrics, Ernst-Moritz-Arndt University, Greifswald, Germany. Heyer@uni-greifswald.de
Ohlinger
Ralf
R
Arndt
Detlef
D
Belau
Antje
A
Nehmzow
Margrit
M
Hosten
Norbert
N
Köhler
Günter
G
D000008:Abdominal Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000556:secondary*; D001859:Bone Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000556:secondary; D003952:Diagnostic Imaging; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000556:secondary*; D016013:Likelihood Functions; D008113:Liver Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000556:secondary*; D008175:Lung Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000556:secondary; D008207:Lymphatic Metastasis / Q000175:diagnosis / Q000473:pathology; D009367:Neoplasm Staging; D011336:Probability; D012189:Retrospective Studies; D012680:Sensitivity and Specificity