Detection of Lymph Node Metastasis in Ovarian Carcinoma and Uterine Corpus Carcinoma by Preoperative Computerized Tomography or Magnetic Resonance Imaging

Sugiyama, Toru; Nishida, Takashi; Ushijima, Kimio; Sato, Norio; Kataoka, Akio; Imaishi, Kiyohisa; Fujiyoshi, Keizo; Yakushiji, M

doi:10.1111/j.1447-0756.1995.tb00911.x

Cited by 25 publications

(9 citation statements)

References 10 publications

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“…Although the identification of metastatic lymph nodes by both CT and MRI is based on measurements of node size, with a short-axis diameter greater than 10 mm or 8 mm being the most accepted criterion for the diagnosis of nodal involvement, these morphological imaging techniques have very low sensitivity: the sensitivity rate for detecting lymph node metastasis in endometrial cancer is between 27% and 66%, and the specificity rate is between 73% and 99% [9][10][11][12][13][14]. The sensitivity rate for detecting lymph node metastasis in uterine cervical cancer is between 30% and 73%, the specificity rate is between 44% and 93% [13,[15][16][17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Accuracy of integrated FDG-PET/contrast-enhanced CT in detecting pelvic and paraaortic lymph node metastasis in patients with uterine cancer

et al. 2009

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The purpose is to evaluate the accuracy of integrated (18)F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography ((CT) with intravenous contrast medium in detecting pelvic and paraaortic lymph node metastasis in patients with uterine cancer, with surgical and histopathological findings used as the reference standard. Forty-five patients with endometrial or uterine cervical cancer underwent radical hysterectomy, including pelvic lymphadenectomy with or without paraaortic lymphadenectomy, after PET/CT. PET/CT findings were interpreted by two experienced radiologists in consensus. The criterion for malignancy on PET/CT images was increased tracer uptake by the lymph node, independent of node size. The overall node-based sensitivity, specificity, PPV, NPV and accuracy of PET/CT for detecting nodal metastases were 51.1% (23/45), 99.8% (1,927/1,931), 85.2% (23/27), 98.9% (1,927/1,949) and 98.7% (1,950/1,976), respectively. The sensitivity for detecting metastatic lesions 4 mm or less in short-axis diameter was 12.5% (2/16), that for between 5 and 9 mm was 66.7% (16/24), and that for 10 mm or larger was 100.0% (5/5). The overall patient-based sensitivity, specificity, positive predictive value ((PPV), negative predictive value (NPV), and accuracy were 50% (6/12), 90.9% (30/33), 66.7% (6/9), 83.3% (30/36) and 80.0% (36/45), respectively. Integrated FDG-PET/contrast-enhanced CT is superior to conventional imaging, but only moderately sensitive in predicting lymph node metastasis preoperatively in patients with uterine cancer.

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Section: Introductionmentioning

confidence: 99%

Accuracy of integrated FDG-PET/contrast-enhanced CT in detecting pelvic and paraaortic lymph node metastasis in patients with uterine cancer

et al. 2009

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“…Therefore, unlike in cervical carcinoma, para-aortic and para-caval LNs may be involved directly without involvement of pelvic LNs. The reported sensitivity and specificity of computed tomography (CT) and magnetic resonance (MR) imaging in the detection of LN metastasis in endometrial cancer on the basis of a short-axis diameter of 8 or 10 mm are 18%-66% and 73%-99%, respectively (6)(7)(8)(9)(10)(11).…”

Section: Genitourinary Imaging: Pet/ct For Evaluation Of Lymph Node Mmentioning

confidence: 99%

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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“…To differentiate malignant from benign LNs, cross-sectional imaging techniques based on node size measurements, with a short-axis diameter of 8-10 mm the widely accepted size criterion for LN metastasis, are used for both CT and MRI, but these morphological imaging modalities are not satisfactory [9][10][11][12][13][14][15][16][17][18][19][20] .…”

Section: Discussionmentioning

confidence: 99%

“…The identification of metastatic LNs by both CT and MRI is based on measurements of node size, with a short-axis diameter greater than 8-10 mm being the most widely accepted criterion for diagnosis of nodal involvement. However, these morphological imaging techniques have very low sensitivity: the sensitivity rate for the detection of LN metastasis in endometrial cancer is between 27% and 66%, while the specificity rate is between 73% and 99% [9][10][11][12][13][14] . The corresponding rates for LN metastasis in uterine cervical cancer are between 30% and 73% and between 44% and 93% [13,[15][16][17][18][19][20] .…”

Section: Introductionmentioning

confidence: 99%

Comparison of DWI and PET/CT in evaluation of lymph node metastasis in uterine cancer

Kitajima

Yamasaki²,

Kaji³

et al. 2012

WJR

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AIM:To investigate diffusion-weighted imaging (�WI) and positron emission tomography and computed tomography (�ET/CT) with Ⅳ contrast for the preoperative evaluation of pelvic lymph node (LN) metastasis in uterine cancer. METHODS:Twenty-five patients with endometrial or cervical cancer who underwent both �WI and �ET/CT before pelvic lymphadenectomy were included in this study. For area specific analysis, LNs were divided into eight regions: both common iliac, external iliac, internal iliac areas, and obturator areas. The classification for malignancy on �WI was a focally abnormal signal intensity in a location that corresponded to the LN chains on the T1WI and T2WI. The criterion for malignancy on �ET/CT images was increased tracer uptake by the LN. RESULTS:A total of 36 pathologically positive LN areas were found in 9 patients. With �WI, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy for detecting metastatic LNs on an LN area-by-area analysis were 83.3%, 51.2%, 27.3%, 93.3% and 57.0%, respectively, while the corresponding values for �ET/CT were 38.9%, 96.3%, 70.0%, 87.8% and 86.0%. Differences in sensitivity, specificity and accuracy were significant (� < 0.0005).CONCLUSION: �WI showed higher sensitivity and lower specificity than PET/CT. Neither DWI nor PET/CT were sufficiently accurate to replace lymphadenectomy.

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Detection of Lymph Node Metastasis in Ovarian Carcinoma and Uterine Corpus Carcinoma by Preoperative Computerized Tomography or Magnetic Resonance Imaging

Abstract: These results indicate that the most practical approach might be to search for enlarged lymph nodes by CT, and to follow-up with MRI when CT scans are questionable.

Cited by 25 publications

References 10 publications

Accuracy of integrated FDG-PET/contrast-enhanced CT in detecting pelvic and paraaortic lymph node metastasis in patients with uterine cancer

Accuracy of integrated FDG-PET/contrast-enhanced CT in detecting pelvic and paraaortic lymph node metastasis in patients with uterine cancer

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

Comparison of DWI and PET/CT in evaluation of lymph node metastasis in uterine cancer

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