title: Comparison of MRI and 18F-FDG PET/CT in the preoperative evaluation of uterine carcinosarcoma.
abstract: OBJECTIVE
  To compare the validities of magnetic resonance imaging (MRI) and (18)F-fluoro-deoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) in preoperative evaluation of uterine carcinosarcoma.
  
  
  METHODS
  Pathologic results of primary tumor lesions and paraaortic and pelvic lymph node (LN) areas were compared with the preoperative image findings. Differences in the validity parameters of both images were compared using McNemar test.
  
  
  RESULTS
  For detecting primary tumor lesions (n=56), the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for (18)F-FDG PET/CT versus MRI were 98.1% versus 98.1% (P=1.000), 33.3% versus 100% (P=0.157), 94.6% versus 98.2% (P=0.500), 96.3% versus 100%, and 50% versus 75%, respectively. For paraaortic LN areas, the values were 77.8% versus 51.9% (P=0.016), 90.2% versus 100% (P=0.025), 85.9% versus 83.3% (P=0.774), 80.8% versus 100%, and 88.5% versus 79.7%, respectively. For pelvic LN areas, the values were 61.1% versus 50% (P=0.125), 86.8% versus 89.5% (P=0.727), 78.6% versus 76.8% (P=0.774), 68.8% versus 69.2%, and 82.5% versus 79.1%, respectively. For extrauterine disease, the patient-based values for (18)F-FDG PET/CT were 100%, 78.9%, 85.7%, 69.2%, and 100%, respectively.
  
  
  CONCLUSIONS
  In patients with uterine carcinosarcoma, (18)F-FDG PET/CT is comparable to MRI in detecting primary uterine lesions. For predicting LN metastases, though (18)F-FDG PET/CT might be insufficient for replacing lymphadenectomy or MRI, it might allow lymphadenectomy to be omitted in poor surgical candidates. For detecting extrauterine metastases, it could also be useful to identify unsuspected disease.
authors.affiliation: Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
authors.forename: Hyun Ju
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
authors.forename: Jeong-Yeol
authors.initials: JY
authors.lastname: Park
authors.affiliation: Department of Nuclear Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
authors.forename: Jong Jin
authors.initials: JJ
authors.lastname: Lee
authors.affiliation: Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
authors.forename: Mi Hyun
authors.initials: MH
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
authors.forename: Dae-Yeon
authors.initials: DY
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
authors.forename: Dae-Shik
authors.initials: DS
authors.lastname: Suh
authors.affiliation: Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
authors.forename: Jong-Hyeok
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
authors.forename: Yong-Man
authors.initials: YM
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
authors.forename: Young-Tak
authors.initials: YT
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
authors.forename: Joo-Hyun
authors.initials: JH
authors.lastname: Nam
mesh_terms: D000368:Aged; D001011:Aorta; D002296:Carcinosarcoma / Q000175:diagnosis* / Q000556:secondary*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D064847:Multimodal Imaging; D009367:Neoplasm Staging; D010388:Pelvis; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D057234:Preoperative Period; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014594:Uterine Neoplasms / Q000175:diagnosis*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: (18)F-FDG PET/CT; MRI; Preoperative evaluation; Uterine MMMT; Uterine carcinosarcoma