title: The efficacy of preoperative positron emission tomography-computed tomography (PET-CT) for detection of lymph node metastasis in cervical and endometrial cancer: clinical and pathological factors influencing it.
abstract: OBJECTIVE
  We studied the diagnostic performance of (18)F-fluoro-2-deoxy-d-glucose-positron emission tomography/computed tomography in cervical and endometrial cancers with particular focus on lymph node metastases.
  
  
  METHODS
  Seventy patients with cervical cancer and 53 with endometrial cancer were imaged with (18)F-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography before lymphadenectomy. We evaluated the diagnostic performance of (18)F-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography using the final pathological diagnoses as the golden standard.
  
  
  RESULTS
  We calculated the sensitivity, specificity, positive predictive value and negative predictive value of (18)F-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography. In cervical cancer, the results evaluated by cases were 33.3, 92.7, 55.6 and 83.6%, respectively. When evaluated by the area of lymph nodes, the results were 30.6, 98.9, 55.0 and 97.0%, respectively. As for endometrial cancer, the results evaluated by cases were 50.0, 93.9, 40.0 and 95.8%, and by area of lymph nodes, 45.0, 99.4, 64.3 and 98.5%, respectively. The limitation of the efficacy was found out by analyzing it by the region of the lymph node, the size of metastatic node, the historical type of tumor in cervical cancer and the prevalence of lymph node metastasis.
  
  
  CONCLUSIONS
  The efficacy of positron emission tomography/computed tomography regarding the detection of lymph node metastasis in cervical and endometrial cancer is not established and has limitations associated with the region of the lymph node, the size of metastasis lesion in lymph node and the pathological type of primary tumor. The indication for the imaging and the interpretation of the results requires consideration for each case by the pretest probability based on the information obtained preoperatively.
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Keio University, Tokyo.
authors.forename: Yuya
authors.initials: Y
authors.lastname: Nogami
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Keio University, Tokyo kbanno@z7.keio.jp.
authors.forename: Kouji
authors.initials: K
authors.lastname: Banno
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Keio University, Tokyo.
authors.forename: Haruko
authors.initials: H
authors.lastname: Irie
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Keio University, Tokyo.
authors.forename: Miho
authors.initials: M
authors.lastname: Iida
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Keio University, Tokyo.
authors.forename: Iori
authors.initials: I
authors.lastname: Kisu
authors.affiliation: Department of Pathology, School of Medicine, Keio University, Tokyo.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Masugi
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Keio University, Tokyo.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Keio University, Tokyo.
authors.forename: Eiichiro
authors.initials: E
authors.lastname: Tominaga
authors.affiliation: Department of Radiology, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: Shigeo
authors.initials: S
authors.lastname: Okuda
authors.affiliation: Department of Radiology, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Murakami
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Keio University, Tokyo.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Aoki
mesh_terms: D000328:Adult; D000368:Aged; D016889:Endometrial Neoplasms / Q000473:pathology*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D049268:Positron-Emission Tomography / Q000379:methods; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D002583:Uterine Cervical Neoplasms / Q000473:pathology*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: clinical oncology; diagnostic imaging; gynecology; lymphatic metastasis; positron-emission tomography