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Validity of positron emission tomography using fluoro-2-deoxyglucose for the preoperative evaluation of endometrial cancer
  1. R. Suzuki*,
  2. E. Miyagi*,
  3. N. Takahashi,
  4. A. Sukegawa*,
  5. A. Suzuki,
  6. I. Koike,
  7. K. Sugiura*,
  8. N. Okamoto,
  9. T. Inoue and
  10. F. Hirahara*
  1. *Departments of Obstetrics and Gynecology and
  2. Departments of Radiology, Yokohama City University School of Medicine, Yokohama, Japan; and
  3. Departments of Division of Cancer Prevention and Cancer Control, Kanagawa Cancer Center Research Institute, Yokohama, Japan
  1. Address correspondence and reprint requests to: Etsuko Miyagi, MD, PhD, Department of Obstetrics and Gynecology, Yokohama City University School of Medicine, Fukuura 3–9, Kanazawa-ku, Yokohama 236-0004, Japan. Email: emiyagi{at}med.yokohama-cu.ac.jp

Abstract

To clarify the validity of positron emission tomography using fluoro-2-deoxyglucose (FDG-PET) for the preoperative evaluation of endometrial cancer, we analyzed the preoperative FDG-PET images of both primary and metastatic lesions of 30 patients with endometrial cancer, and compared them with computed tomography (CT) and/or magnetic resonance imaging (MRI) images and the results of postoperative pathologic findings. As to the primary lesions, FDG-PET could easily identify the cancer, and the sensitivity was 96.7%, which tended to be higher than that of 83.3% by CT/MRI. As to the evaluation of retroperitoneal lymph node metastasis, FDG-PET could detect none of five cases of lymph node metastatic lesions of up to 0.6 cm in diameter but had higher specificity (100%) compared with CT/MRI (85.7%). The sensitivity of FDG-PET for detection of extrauterine lesions excluding retroperitoneal lymph nodes was 83.3% and was superior to that of CT/MRI (66.7%), although there was no difference in the specificity between the modalities (100%). The diagnostic ability of FDG-PET was limited if used alone, but FDG-PET gave additional information especially with regard to the extrauterine lesions whose significance could not be determined on CT/MRI. However, we also found that FDG-PET could not identify any lymph node metastasis less than 1 cm in diameter; therefore, a negative finding of lymph node metastasis on FDG-PET should not be interpreted as a reason for omitting retroperitoneal lymph node dissection for the precise surgical staging of endometrial cancer

  • endometrial cancer
  • FDG-PET
  • preoperative diagnosis

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Footnotes

  • The first and second authors contributed equally to this work.

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