Clinical value of FDG-PET for preoperative evaluation of endometrial cancer

Suga, Tetsuya; Nakamoto, Yuji; Saga, Tsuneo; Higashi, Tatsuya; Hamanaka, Yasuyo; Tatsumi, Mitsuaki; Hayashida, Kentaro; Hara, Tadashi; Konishi, Ikuo; Fujii, Shingo; Togashi, Kaori

doi:10.1007/s12149-011-0474-2

Cited by 19 publications

(8 citation statements)

References 21 publications

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“…The spectra of patients included in the current meta-analysis were not wide enough for evaluation of specificity. Actually only 4 studies evaluated the specificity, 25,29,32,34 and 2 of them included only patients with physiological uterine activity without any endometrial tumoral lesion for this purpose. 25,32 Future studies should be conducted on a wide range of patients with factors suggestive of endometrial cancer for better evaluation of specificity.…”

Section: Detection Of Primary Tumormentioning

confidence: 99%

“…Potential locations and pathologies with 18 F-FDG uptake that could cause false-positive studies were as follows: benign lung lesions, 18,22 bowels, 18 second malignancies, 19,22,29 colon adenoma, 22 and reactive lymph nodes (besides pelvic and para-aortic lesions). 22,27 Limitations Heterogeneity of included studies is an important issue that should be addressed in all meta-analyses.…”

Section: Distant Metastasesmentioning

confidence: 99%

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Diagnostic Performance of Fluorine 18 Fluorodeoxyglucose Positron Emission Tomography Imaging for Detection of Primary Lesion and Staging of Endometrial Cancer Patients: Systematic Review and Meta-Analysis of the Literature

Kakhki

Shahriari

Treglia

et al. 2013

Int J Gynecol Cancer

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Because of low sensitivity, diagnostic utility of (18)F-FDG PET imaging is limited in primary tumor detection and lymph node staging of endometrial cancer patients. However, high specificities ensure high positive predictive values in these 2 indications. Diagnostic performance of (18)F-FDG PET imaging is much better in detection of distant metastases. Larger studies with better design are needed to draw any more definite conclusion.

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Section: Detection Of Primary Tumormentioning

confidence: 99%

Section: Distant Metastasesmentioning

confidence: 99%

Diagnostic Performance of Fluorine 18 Fluorodeoxyglucose Positron Emission Tomography Imaging for Detection of Primary Lesion and Staging of Endometrial Cancer Patients: Systematic Review and Meta-Analysis of the Literature

Kakhki

Shahriari

Treglia

et al. 2013

Int J Gynecol Cancer

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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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“…Integrated positron emission tomography/CT (PET/ CT) with 18 F-fluorodeoxyglucose (FDG) that gives combined metabolic and anatomical information together in a single session allows the assessment of endometrial tumours [14] . 18 F-FDG PET/CT is a non-invasive diagnostic method that helps to image tumor distribution and metabolism in various malignancies.…”

Section: Introductionmentioning

confidence: 99%

Preoperative <sup>18</sup>F-Fluorodeoxyglucose Positron Emission Tomography/CT in Prediction of Uterine Risk Factors and Lymph Node Metastasis: An Analysis of 111 Endometrioid Endometrial Cancer Patients

Atakul

Taşkın²,

Soydal³

et al. 2016

Gynecol Obstet Invest

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Introduction: This study evaluated the role of ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography/CT (PET/CT) in the detection of lymph node metastases and the association between uterine maximum standardized uptake values (SUVmax) and the histopathological features in endometrial cancer patients. Materials and Methods: Patients with endometrioid endometrial cancer underwent preoperative ¹⁸F-FDG PET/CT imaging and were staged surgically. ¹⁸F-FDG PET/CT findings were compared with final pathology reports. Grade 3 histology or grade 2 histology with myometrial invasion ≥50% was established as a high risk feature. Results: One hundred and eleven patients were analysed. Sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of ¹⁸F-FDG PET/CT in the detection of lymph node metastasis in all patients (n = 111) were 67, 96, 93, 60 and 97%, respectively. In the high-risk group, sensitivity, specificity, accuracy, PPV and NPV of ¹⁸F-FDG PET/CT were 75, 92, 91, 60 and 96%, respectively. Uterine SUVmax was found to be associated with myometrial invasion, grade and cervical stromal involvement. Conclusions:¹⁸F-FDG PET/CT has limited sensitivity and accuracy in detecting lymph node metastasis. Therefore, as of now, it is not accepted as a modality that can replace lymphadenectomy. SUVmax values can predict high-risk factors.

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Clinical value of FDG-PET for preoperative evaluation of endometrial cancer

Abstract: FDG-PET had a reasonably high diagnostic accuracy in endometrial cancer. Although the number of cases with clinical impact was limited, additional information by PET was obtained in one-third of the cases.

Cited by 19 publications

References 21 publications

Diagnostic Performance of Fluorine 18 Fluorodeoxyglucose Positron Emission Tomography Imaging for Detection of Primary Lesion and Staging of Endometrial Cancer Patients: Systematic Review and Meta-Analysis of the Literature

Diagnostic Performance of Fluorine 18 Fluorodeoxyglucose Positron Emission Tomography Imaging for Detection of Primary Lesion and Staging of Endometrial Cancer Patients: Systematic Review and Meta-Analysis of the Literature

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

Preoperative <sup>18</sup>F-Fluorodeoxyglucose Positron Emission Tomography/CT in Prediction of Uterine Risk Factors and Lymph Node Metastasis: An Analysis of 111 Endometrioid Endometrial Cancer Patients

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