Preoperative detecting metastases of cervical cancer in pelvic and para-aortic lymph nodes: comparison of integrated 18F-FDG PET/CT with or without contrast enhancement

RADIOCHEMISTRY, RADIOPHARMACEUTICALS AND NUCLEAR MEDICINE

Preoperative detecting metastases of cervical cancer in pelvic and para-aortic lymph nodes: comparison of integrated ¹⁸F-FDG PET/CT with or without contrast enhancement

XING Yan，

ZHAO Jinhua，

SONG Jianhua，

CHEN Xiang，

QIAO Wenli

Nuclear Science and Techniques

Vol.23, No.5

pp.305-311

Published in print 20 Oct 2012

DOI：10.13538/j.1001-8042/nst.23.205-311

42400

Purpose:

Compared the performance of contrast-enhanced PET/CT and non-enhanced PET/CT for preoperatively detecting pelvic and para-aortic lymph node metastases in patients with cervical cancer.

Methods:

This prospective study included 72 patients with clinically M0 cervical cancer. They underwent surgery within two weeks of PET/CT imaging. Imaging consisted of a whole-body PET/CT protocol without intravenous contrast, followed by abdominal and pelvic PET/CT protocol including contrast-enhanced CT. We compared the diagnostic efficiency between the methods on per-patient and per-lesion basis.

Results:

Patient-based analysis showed that the sensitivity, specificity, and accuracy of contrast-enhanced PET/CT were 63.6% (14/22), 94.0% (47/50), and 84.7%(61/72), respectively, whereas those of non-enhanced PET/CT were 54.5% (12/22), 88.0% (44/50), and 77.8% (56/72), respectively, and those of enhanced CT alone were 36.4% (8/22), 80.0% (40/50), and 66.7% (48/72), respectively. Lesion-based analysis showed that the sensitivity, specificity, and accuracy of contrast-enhanced PET/CT were 77.7% (87/112), 98.7%(938/950), and 96.5% (1025/1062), respectively, whereas those of non-enhanced PET/CT were 69.6% (78/112), 97.5% (926/950), and 94.5% (1004/1062), respectively, and those of enhanced CT were 54.4% (61/112), 96.1% (913/950), and 91.7% (974/1062), respectively. Contrast-enhanced PET/CT had the best sensitivity, specificity and accuracy. Although patient-based analysis showed no significant difference between contrast-enhanced PET/CT and non-enhanced PET/CT (p =0.540, 0.295 and 0.286), the specificity and accuracy of these two methods were significantly different on lesion-based analysis (p =0.043 and 0.027).

Uterine cervical cancerNodal stagingFDGPET/CTContrast enhanced CT

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