title: Comparison of DWI and PET/CT in evaluation of lymph node metastasis in uterine cancer.
abstract: OBJECTIVE
  To investigate diffusion-weighted imaging (DWI) and positron emission tomography and computed tomography (PET/CT) with IV contrast for the preoperative evaluation of pelvic lymph node (LN) metastasis in uterine cancer.
  
  
  METHODS
  Twenty-five patients with endometrial or cervical cancer who underwent both DWI and PET/CT before pelvic lymphadenectomy were included in this study. For area specific analysis, LNs were divided into eight regions: both common iliac, external iliac, internal iliac areas, and obturator areas. The classification for malignancy on DWI was a focally abnormal signal intensity in a location that corresponded to the LN chains on the T1WI and T2WI. The criterion for malignancy on PET/CT images was increased tracer uptake by the LN.
  
  
  RESULTS
  A total of 36 pathologically positive LN areas were found in 9 patients. With DWI, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy for detecting metastatic LNs on an LN area-by-area analysis were 83.3%, 51.2%, 27.3%, 93.3% and 57.0%, respectively, while the corresponding values for PET/CT were 38.9%, 96.3%, 70.0%, 87.8% and 86.0%. Differences in sensitivity, specificity and accuracy were significant (P < 0.0005).
  
  
  CONCLUSIONS
  DWI showed higher sensitivity and lower specificity than PET/CT. Neither DWI nor PET/CT were sufficiently accurate to replace lymphadenectomy.
authors: Kazuhiro Kitajima, Kazuro Sugimura, Department of Radiology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan.
authors: Kazuhiro
authors: K
authors: Kitajima
authors: Erena
authors: E
authors: Yamasaki
authors: Yasushi
authors: Y
authors: Kaji
authors: Koji
authors: K
authors: Murakami
authors: Kazuro
authors: K
authors: Sugimura