title: Additional value of MR/PET fusion compared with PET/CT in the detection of lymph node metastases in cervical cancer patients.
abstract: We evaluated the additional diagnostic value of magnetic resonance/positron emission tomography (MR/PET) fusion in the detection of metastatic lymph nodes in cervical cancer patients. Seventy nine patients with FIGO stage IB-IVA cervical cancer who had undergone both magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT) before lymphadenectomy were included in this study. Image analysis was first performed with PET/CT images only. A second analysis was then performed with MR/PET fused images that focused on the additional information obtained from the MR images. Lymphadenectomy involved removing all visible lymph nodes in the surgical field. To enable nodal group-specific comparisons, para-aortic and pelvic lymph nodes were divided into seven nodal groups: para-aortic, both common iliac, both external iliac and both internal iliac/obturator areas. Histopathological evaluation of lymph nodes has been the diagnostic standard. The value of the additional information from the MR images was evaluated by means of receiver operating characteristic (ROC) analysis. Fused MR/PET rendered readers to detect six more metastatic lymph node groups. The sensitivity and specificity of PET/CT and fused MR/PET were 44.1%, 93.9% and 54.2%, 92.7% respectively. The ROC analysis demonstrated a higher diagnostic performance of fused MR/PET compared to PET/CT alone for detecting lymph node metastases (p=0.0259). The findings of this study demonstrate the additional diagnostic value of fused MR/PET images compared with PET/CT in the detection of metastatic lymph nodes in patients with uterine cervical cancer.
authors.affiliation: Department of Radiology, Asan Medical Center, University of Ulsan, 388-1, Poongnap-dong, Songpa-gu, Seoul 138-736, Republic of Korea.
authors.forename: Seok-Ki
authors.initials: SK
authors.lastname: Kim
authors.forename: Hyuck Jae
authors.initials: HJ
authors.lastname: Choi
authors.forename: Sang-Yoon
authors.initials: SY
authors.lastname: Park
authors.forename: Ho-Young
authors.initials: HY
authors.lastname: Lee
authors.forename: Sang-Soo
authors.initials: SS
authors.lastname: Seo
authors.forename: Chong Woo
authors.initials: CW
authors.lastname: Yoo
authors.forename: Dae Chul
authors.initials: DC
authors.lastname: Jung
authors.forename: Sokbom
authors.initials: S
authors.lastname: Kang
authors.forename: Kyung-Sik
authors.initials: KS
authors.lastname: Cho
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008197:Lymph Node Excision / Q000706:statistics & numerical data; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000601:surgery; D008207:Lymphatic Metastasis / Q000175:diagnosis; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18