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Nuclear Medicine |
1 From the Departments of Nuclear Medicine (M.J.R., S.H., M.M., E.M., T.M.K.), Diagnostic Radiology (C.E.B.), Gynecology and Obstetrics (D.V.), and the Institute of Pathology (C.I.), University Hospital of Freiburg, Germany. Received February 22, 2000; revision requested April 8; revision received July 25; accepted August 29. Address correspondence to M.J.R., Department of Nuclear Medicine, University Hospital of Bonn, Sigmund-Freud-Strasse 25, D-53127 Bonn, Germany (e-mail: michael.reinhardt@meb.uni-bonn.de).
PURPOSE: To compare the diagnostic accuracy of magnetic resonance (MR) imaging with that of positron emission tomography (PET) with 2-[fluorine 18]fluoro-2-deoxy-D-glucose (FDG) for detecting metastatic lymph nodes in patients with cervical cancer.
MATERIALS AND METHODS: Before radical hysterectomy and pelvic lymphadenectomy in 35 patients with International Federation of Gynecology and Obstetrics stage IB or II cervical cancer, abdominal FDG-PET and MR imaging were performed. Malignancy criteria were a lymph node diameter of 1 cm or more at MR imaging and a focally increased FDG uptake at PET. The findings of FDG-PET and MR imaging were compared with histologic findings.
RESULTS: Histologic examination revealed pN0-stage cancer in 24 patients and pN1-stage cancer in 11 patients. On a patient basis, node staging resulted in sensitivities of 0.91 with FDG-PET and 0.73 with MR imaging and specificities of 1.00 with FDG-PET and 0.83 with MR imaging. The positive predictive value (PPV) of FDG-PET was 1.00 and that of MR imaging, 0.67 (not significant). The metastatic involvement of lymph node sites was identified at FDG-PET with a PPV of 0.90; at MR imaging, 0.64 (P < .05, Fisher exact test).
CONCLUSION: Metabolic imaging with FDG-PET is an alternative to morphologic MR imaging for detecting metastatic lymph nodes in patients with cervical cancer.
Index terms: Lymphatic system, MR, 80.121411, 994.33 • Lymphatic system, neoplasms, 994.33 • Positron emission tomography (PET), 80.12163 • Uterine neoplasms, 859.322, 859.324, 859.329
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