High-grade endometrial cancer: value of [(18)F]FDG PET/CT in preoperative staging.
OBJECTIVE
The purpose of this study was to assess the value of 2-[F]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography ([F]FDG PET/CT) in the primary staging of high-risk endometrial cancer patients.


METHODS
This retrospective study was conducted on 32 consecutive patients with histological diagnosis of primary high-risk endometrial cancer, who underwent PET/CT with [F]FDG in addition to conventional clinical and instrumental staging procedures. After surgery, [F]FDG PET/CT findings were correlated with pathological findings on a patient-by-patient basis. The diagnostic accuracy of [F]FDG PET/CT for primary cancer detection, lymph nodal involvement and distant metastases was assessed.


RESULTS
[F]FDG PET/CT could correctly detect primary tumor in 29 of the 32 high-risk patients, with a sensitivity of 90.6%. The overall [F]FDG PET/CT patient-based sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 57.1, 100.0, 100.0, 86.4, and 88.5%, respectively, for revealing lymph nodal neoplastic involvement, and 100.0, 96.0, 87.5, 100.0, 96.9%, respectively, for detecting distant metastases. In particular, while the suspicion of distant metastases was documented by conventional imaging in only two patients, [F]FDG PET/CT correctly identified metastatic lesions in seven patients (21.9% of cases).


CONCLUSIONS
The major benefit provided in high-grade tumor patients by the use of [F]FDG PET/CT in the primary staging of endometrial cancer is its ability to accurately detect distant metastases in the abdomen and extra-abdominal regions. [F]FDG PET/CT adds relevant information that may influence patient management.
Picchio
Maria
M
Department of Nuclear Medicine, San Raffaele Scientific Institute, Milan, Italy. picchio.maria@hsr.it
Mangili
Giorgia
G
Samanes Gajate
Ana M
AM
De Marzi
Patrizia
P
Spinapolice
Elena G
EG
Mapelli
Paola
P
Giovacchini
Giampiero
G
Sigismondi
Cristina
C
Viganò
Riccardo
R
Sironi
Sandro
S
Messa
Cristina
C
D000328:Adult; D000368:Aged; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D019788:Fluorodeoxyglucose F18