title: Role of 18F-FDG PET/CT in detecting pelvic lymph-node metastases in patients with early-stage uterine cervical cancer: comparison with MRI findings.
abstract: OBJECTIVE
  This study aimed to investigate the applied value of F-fluoro-2-dexoxyglucose (F-FDG) PET/computed tomography (CT) and MRI in detecting lymph-node metastasis in early-stage cervical cancer.
  
  
  METHODS
  A retrospective study was performed on 87 early-stage cervical cancer patients evaluated with PET/CT and pelvic MRI before surgery. Histopathological evaluation of lymph nodes served as the diagnostic standard. F-FDG PET/CT and MRI images were analyzed and correlated with histopathological findings.
  
  
  RESULTS
  The overall node-based sensitivity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of PET/CT were 91% (61/67), 78.2% (61/78), 99.4% (1079/1085), and 98% (1140/1163), respectively, which were higher than the corresponding values of MRI, at 37.3% (25/67), 61% (25/41), 96.3% (1080/1122), and 95% (1105/1163) (P<0.034). The difference in diagnostic efficacy for identifying node-based metastases between PET/CT and MRI was significant (PET/CT vs. MRI, 0.719 vs. 0.587, P=0.017). Meanwhile, the overall patient-based sensitivity, PPV, NPV, and accuracy of PET/CT were 100% (34/34), 87.2% (34/39), 100% (48/48), and 94.3% (82/87), respectively, whereas the corresponding MRI values were 44% (15/34), 65% (15/23),74% (45/61), and 69% (60/87) (P<0.04). The difference in diagnostic efficacy for identifying patient-based metastases between PET/CT and MRI was significant (PET/CT vs. MRI, 0.974 vs. 0.705, P<0.001).
  
  
  CONCLUSIONS
  PET/CT has been proven to be valuable in detecting lymph-node metastases. Compared with MRI, PET/CT has higher sensitivity, PPV, NPV, and accuracy in patients with early-stage cervical cancer for detecting lymphatic metastases.
authors.affiliation: aDepartment of Nuclear Medicine, Qilu Hospital, Shandong University bDepartment of Nuclear Medicine, Shandong Provincial Hospital affiliated to Shandong University, Jinan, Shandong, People's Republic of China.
authors.forename: Kuan
authors.initials: K
authors.lastname: Lv
authors.forename: Hui-min
authors.initials: HM
authors.lastname: Guo
authors.forename: Ying-jv
authors.initials: YJ
authors.lastname: Lu
authors.forename: Zhi-xing
authors.initials: ZX
authors.lastname: Wu
authors.forename: Ke
authors.initials: K
authors.lastname: Zhang
authors.forename: Jian-kui
authors.initials: JK
authors.lastname: Han
mesh_terms: D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D064847:Multimodal Imaging; D009367:Neoplasm Staging; D010388:Pelvis; D049268:Positron-Emission Tomography; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology*
chemical_list: D019788:Fluorodeoxyglucose F18