Nucl Med Mol Imaging.  2018 Dec;52(6):445-452. 10.1007/s13139-018-0549-2.

Diagnostic Value of ¹⁸F-FDG PET/CT and MRI in the Preoperative Evaluation of Uterine Carcinosarcoma

• Kim S
• Kim YT
• Kim S
• Kim SW
• Lee JY
• Kang WJ

• KMID: 2431982
• DOI: http://doi.org/10.1007/s13139-018-0549-2

Abstract

PURPOSE
This study aimed to compare the diagnostic value of ¹â¸F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) and magnetic resonance imaging (MRI) in the preoperative evaluation of uterine carcinosarcoma.
METHODS
Fifty-four women with pathologically confirmed uterine carcinosarcoma who underwent preoperative FDG PET/CT and MRI from June 2006 to November 2016 were included. Pathologic findings from primary tumor lesions, para-aortic and pelvic lymph node (LN) areas, and peritoneal seeding lesions were compared with the FDG PET/CT and MRI findings. The maximum standardized uptake value (SUVmax) of the primary tumor and LN was obtained. The tumor-to-liver ratio (TLR) was calculated by dividing the SUVmax of the primary tumor or LN by the mean SUVof the liver.
RESULTS
For detecting primary tumor lesions (n = 54), the sensitivity and accuracy of FDGPET/CT (53/54) andMRI (53/54) were 98.2%. The sensitivity, specificity, and accuracy of FDG PET/CT versus MRI were as follows: 63.2% (12/19) versus 26.3% (5/19), 100% (35/35) versus 100% (35/35), and 87.0% versus 74.0%, respectively, for pelvic LN areas (p = 0.016); 85.7% (12/14) versus 42.9%(6/14), 90%(36/40) versus 97.5%(39/40), and 88.9%versus 83.3%, respectively, for para-aortic LN areas (p = 0.004); and 59.4% (19/32) versus 50% (16/32), 100% (22/22) versus 100% (22/22), and 75.9% versus 70.4%, respectively, for peritoneal seeding lesions (p = 0.250). For distant metastasis, the sensitivity, specificity, and accuracy of FDG PET/CTwere 100 (8/8), 97.8 (45/46), and 98.2%, respectively.
CONCLUSION
FDG PET/CT showed superior diagnostic accuracy compared to MRI in detecting pelvic and para-aortic LN metastasis in patients with uterine carcinosarcoma. Moreover, FDG PET/CT facilitated the identification of distant metastasis.

Keyword

Uterine carcinosarcoma; ¹⁸F-Fluorodeoxyglucose; Positron emission tomography; Magnetic resonance imaging

MeSH Terms

Carcinosarcoma*
Electrons
Female
Humans
Liver
Lymph Nodes
Magnetic Resonance Imaging*
Neoplasm Metastasis
Positron-Emission Tomography
Positron-Emission Tomography and Computed Tomography*
Sensitivity and Specificity