18F-FDG PET or PET/CT for detection of metastatic lymph nodes in patients with endometrial cancer: A systematic review and meta-analysis

Chang, Ming Che; Chen, Jin Hua; Liang, Ji An; Yang, Kuang Tao; Cheng, Kai Yuan; Kao, Chia Hung

doi:10.1016/j.ejrad.2012.01.024

Cited by 88 publications

(57 citation statements)

References 28 publications

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“…between the two in the abdomen or pelvis (P = .11 and .27, respectively). Our results are similar to those of a metaanalysis published in 2012 by Chang et al (25), which reported a sensitivity of 0.63 and a specificity of 0.95. However, our sensitivity is slightly lower than that in another meta-analysis, which showed a sensitivity of 0.72 (95% CI: 0.64, 0.80) (26).…”

Section: Pathologic Results In the Removed Lnssupporting

confidence: 82%

Utility of PET/CT to Evaluate Retroperitoneal Lymph Node Metastasis in High-Risk Endometrial Cancer: Results of ACRIN 6671/GOG 0233 Trial

et al. 2017

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Section: Pathologic Results In the Removed Lnssupporting

confidence: 82%

Utility of PET/CT to Evaluate Retroperitoneal Lymph Node Metastasis in High-Risk Endometrial Cancer: Results of ACRIN 6671/GOG 0233 Trial

et al. 2017

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“…The sensitivity is within the higher range compared with most previous studies (60%-83%) (12)(13)(14)(15)22), whereas the specificity is within the lower range compared with previous studies (93%-100%) (12)(13)(14)(15)22). Accuracy seems quite similar to that reported recently (90%-95%) (12,13,22).…”

Section: Discussionsupporting

confidence: 65%

“…18 F-FDG PET/CT combines morphologic and physiologic techniques and is the preferred imaging method for various cancers (11). Although several studies have suggested that 18 F-FDG PET/CT can be beneficial preoperatively in endometrial cancer patients (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23), its clinical role in risk stratification of such patients is not well defined. Furthermore, the value of various quantitative tumor parameters and the corresponding optimal cutoffs for the prediction of tumor stage and prognosis are largely unexplored.…”

mentioning

confidence: 99%

Metabolic Tumor Volume on ¹⁸F-FDG PET/CT Improves Preoperative Identification of High-Risk Endometrial Carcinoma Patients

et al. 2015

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Our objective was to prospectively explore the diagnostic value of 18 F-FDG PET/CT for preoperative staging in endometrial carcinomas and to investigate whether 18 F-FDG PET-specific quantitative tumor parameters reflect clinical and histologic characteristics. Methods: Preoperative 18 F-FDG PET/CT was prospectively performed on 129 consecutive endometrial carcinoma patients. Two physicians who did not know the clinical findings or staging results independently reviewed the images, assessing primary tumor, cervical stroma involvement and metastatic spread, and determining maximum and mean standardized uptake value (SUV max and SUV mean , respectively) for tumor, metabolic tumor volume (MTV), and total lesion glycolysis (TLG). All parameters were analyzed in relation to histomorphologic and clinical tumor characteristics. Receiver-operatingcharacteristic curves for identification of deep myometrial invasion and lymph node metastases were generated, and MTV cutoffs for predicting deep myometrial invasion and lymph node metastases were calculated. Results: The sensitivity, specificity, and accuracy of 18 F-FDG PET/CT for the detection of lymph node metastases were 77%-85%, 91%-96%, and 89%-93%, respectively. SUV max , SUV mean , MTV, and TLG were significantly related to deep myometrial invasion, presence of lymph node metastases, and high histologic grade (P , 0.015 for all) and independently predicted deep myometrial invasion (P , 0.015) and lymph node metastases (P , 0.025) after adjustment for preoperative histologic risk (based on subtype and grade) in endometrial biopsies. Optimal cutoffs for MTV in predicting deep myometrial invasion (20 mL) and the presence of lymph node metastases (30 mL) yielded odds ratios of 7.8 (P , 0.001) and 16.5 (P 5 0.001), respectively. Conclusion: 18 F-FDG PET/CT represents a clinically valuable tool for preoperatively evaluating the presence of lymph node metastases in endometrial carcinoma patients. Applying MTV cutoffs for the prediction of deep myometrial invasion and lymph node metastases may increase diagnostic accuracy and aid preoperative identification of high-risk patients, enabling restriction of lymphadenectomy for patients with a low risk of aggressive disease.

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“…It is important to know or predict the stage of disease before the operation to perform full staging surgery. In previous studies, it was found that PET/CT has moderate sensitivity and high specificity for detecting nodal metastasis (29)(30)(31) and high sensitivity and specificy for detecting metastatic disease (32). Authors concluded that PET/CT is not a substitute for lymphadenectomy.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Positron-Emision Tomography/Computed Tomography Findings in Endometrial Cancer: A Study of 30 Cases

Altın

Kasapoglu

Tuncer

2017

Gynecol Obstet Reprod Med

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OBJECTIVE:The aim of this study was to find out if preoperative PET/CT could be a substitute for staging surgery and whether SUVmax values correlate with prognostic factors of endometrium cancer.STUDY DESIGN: 30 patients to whom18-fluorodeoxyglucose PET/CT scan was performed preoperatively were analyzed retrospectively. Standardized uptake value (SUV) was calculated on PET images. PET findings were compared with surgical and pathological findings. RESULTS:SUVmax of the endometrioid type tumors were significantly higher than non-endometrioid types (p: 0.042). SUVmax significantly differ between histologic grades (p: 0.042). SUVmax did not differ between patients who had myometrial invasion less or more than 50% and who had lymphovascular invasion or not. There was not a significant difference between SUVmax and FIGO stages also. Possibility of extra-uterine lesion in PET/CT were significantly higher in late stages (p: 0.004). Sensitivity and specificity of PET/CT for detection of beyond stage 1 disease were 50% and 67% respectively and sensitivity and specificity of PET/CT for detection of lymph node metastasis were 40% and 86% respectively. CONCLUSION:PET/CT has moderate sensitivity for pre-operative detection of beyond stage 1 cancers but it has a high specificity and low-moderate sensitivity for detection of lymph node metastasis but has high specificity. Because the positive likelihood ratios are relatively low, PET/CT cannot be a substitute for staging surgery.

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18F-FDG PET or PET/CT for detection of metastatic lymph nodes in patients with endometrial cancer: A systematic review and meta-analysis

Cited by 88 publications

References 28 publications

Utility of PET/CT to Evaluate Retroperitoneal Lymph Node Metastasis in High-Risk Endometrial Cancer: Results of ACRIN 6671/GOG 0233 Trial

Utility of PET/CT to Evaluate Retroperitoneal Lymph Node Metastasis in High-Risk Endometrial Cancer: Results of ACRIN 6671/GOG 0233 Trial

Metabolic Tumor Volume on ¹⁸F-FDG PET/CT Improves Preoperative Identification of High-Risk Endometrial Carcinoma Patients

Preoperative Positron-Emision Tomography/Computed Tomography Findings in Endometrial Cancer: A Study of 30 Cases

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18F-FDG PET or PET/CT for detection of metastatic lymph nodes in patients with endometrial cancer: A systematic review and meta-analysis

Cited by 88 publications

References 28 publications

Utility of PET/CT to Evaluate Retroperitoneal Lymph Node Metastasis in High-Risk Endometrial Cancer: Results of ACRIN 6671/GOG 0233 Trial

Utility of PET/CT to Evaluate Retroperitoneal Lymph Node Metastasis in High-Risk Endometrial Cancer: Results of ACRIN 6671/GOG 0233 Trial

Metabolic Tumor Volume on 18F-FDG PET/CT Improves Preoperative Identification of High-Risk Endometrial Carcinoma Patients

Preoperative Positron-Emision Tomography/Computed Tomography Findings in Endometrial Cancer: A Study of 30 Cases

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Metabolic Tumor Volume on ¹⁸F-FDG PET/CT Improves Preoperative Identification of High-Risk Endometrial Carcinoma Patients