title: A novel diagnostic criterion for lymph node metastasis in cervical cancer using multi-detector computed tomography.
abstract: OBJECTIVE
  The sensitivity of the current 10mm cut-off diameter that is used to diagnose lymph node (LN) metastasis is too low. This is the first study to develop a new criterion to diagnose LN metastasis in a region-by-region manner using multi-detector computed tomography (MDCT).
  
  
  METHODS
  1) The short-axis diameter of the LNs in MDCT images from 1-mm slices obtained immediately prior to surgery was compared with the pathological diagnosis in 78 uterine cervical cancer patients undergoing primary surgery. For the region-by-region analysis, we divided para-aortic and pelvic spaces into 13 regions. 2) In 28 cases in which patients received neoadjuvant chemotherapy (NAC) followed by surgery, we compared MDCT images before and after NAC.
  
  
  RESULTS
  1) The optimal cut-off in the region-by-region analysis was 5mm, yielding 71% sensitivity and 79% specificity. 2) NAC significantly decreased LN size (p<0.0001). NAC decreased the number of swollen LN regions (>5mm) from 51% (81/158) to 26% (41/158).
  
  
  CONCLUSIONS
  The new criterion developed using MDCT could be effective for accurately assessing LN status. It also facilitates the assessment of NAC efficacy regarding the eradication of LN metastases.
authors.affiliation: Department of Gynecology and Obstetrics, Kyoto University, Graduate School of Medicine, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Yamanoi
authors.forename: Noriomi
authors.initials: N
authors.lastname: Matsumura
authors.forename: Aki
authors.initials: A
authors.lastname: Kido
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Baba
authors.forename: Junzo
authors.initials: J
authors.lastname: Hamanishi
authors.forename: Ken
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Yoshioka
authors.forename: Hisham
authors.initials: H
authors.lastname: Abou Taleb
authors.forename: Kaori
authors.initials: K
authors.lastname: Togashi
authors.forename: Ikuo
authors.initials: I
authors.lastname: Konishi
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D000077146:Irinotecan; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D061330:Multidetector Computed Tomography / Q000379:methods*; D020360:Neoadjuvant Therapy; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D057285:Precision Medicine; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery
chemical_list: D009944:Organoplatinum Compounds; D000077146:Irinotecan; C053989:nedaplatin; D002166:Camptothecin
keywords: Cervical cancer; Lymph node metastasis; Multi-detector computed tomography (MDCT); Neoadjuvant chemotherapy (NAC)