The accuracy of integrated [ 18 F] fluorodeoxyglucose-positron emission tomography/computed tomography in detection of pelvic and para-aortic nodal metastasis in patients with high risk endometrial cancer
Lymph nodal (LN) metastasis is the most important prognostic factor in high-risk endometrial cancer. However, the benefit of routine lymphadenectomy in endometrial cancer is controversial. This study was conducted to assess the accuracy of [ 18 F] fluorodeoxyglucose-positron emission tomography/comp...
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2014-07-01
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| Series: | World Journal of Nuclear Medicine |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.4103/1450-1147.144817 |
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| author | Nikhil Gholkar Subhas Saha GRV Prasad Anish Bhattacharya Radhika Srinivasan Vanita Suri |
| author_facet | Nikhil Gholkar Subhas Saha GRV Prasad Anish Bhattacharya Radhika Srinivasan Vanita Suri |
| author_sort | Nikhil Gholkar |
| collection | DOAJ |
| description | Lymph nodal (LN) metastasis is the most important prognostic factor in high-risk endometrial cancer. However, the benefit of routine lymphadenectomy in endometrial cancer is controversial. This study was conducted to assess the accuracy of [ 18 F] fluorodeoxyglucose-positron emission tomography/computed tomography ([ 18 F] FDG-PET/CT) in detection of pelvic and para-aortic nodal metastases in high-risk endometrial cancer. 20 patients with high-risk endometrial carcinoma underwent [ 18 F] FDG-PET/CT followed by total abdominal hysterectomy, bilateral salpingo-oophorectomy and systematic pelvic lymphadenectomy with or without para-aortic lymphadenectomy. The findings on histopathology were compared with [ 18 F] FDG-PET/CT findings to calculate the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of [ 18 F] FDG-PET/CT. The pelvic nodal findings were analyzed on a patient and nodal chain based criteria. The para-aortic nodal findings were reported separately. Histopathology documented nodal involvement in two patients (10%). For detection of pelvic nodes, on a patient based analysis, [ 18 F] FDG-PET/CT had a sensitivity of 100%, specificity of 61.11%, PPV of 22.22%, NPV of 100% and accuracy of 65% and on a nodal chain based analysis, [ 18 F] FDG-PET/CT had a sensitivity of 100%, specificity of 80%, PPV of 20%, NPV of 100%, and accuracy of 80.95%. For detection of para-aortic nodes, [ 18 F] FDG-PET/CT had sensitivity of 100%, specificity of 66.67%, PPV of 20%, NPV of 100%, and accuracy of 69.23%. Although [ 18 F] FDG-PET/CT has high sensitivity for detection of LN metastasis in endometrial carcinoma, it had moderate accuracy and high false positivity. However, the high NPV is important in selecting patients in whom lymphadenectomy may be omitted. |
| format | Article |
| id | doaj-art-1ab7666e6cc6409f9dae154bbaeb1473 |
| institution | DOAJ |
| issn | 1450-1147 1607-3312 |
| language | English |
| publishDate | 2014-07-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
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| spelling | doaj-art-1ab7666e6cc6409f9dae154bbaeb14732025-08-20T02:54:43ZengThieme Medical and Scientific Publishers Pvt. Ltd.World Journal of Nuclear Medicine1450-11471607-33122014-07-01130317017710.4103/1450-1147.144817The accuracy of integrated [ 18 F] fluorodeoxyglucose-positron emission tomography/computed tomography in detection of pelvic and para-aortic nodal metastasis in patients with high risk endometrial cancerNikhil Gholkar0Subhas Saha1GRV Prasad2Anish Bhattacharya3Radhika Srinivasan4Vanita Suri5Department of Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research, ChandigarhDepartment of Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research, ChandigarhDepartment of Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research, ChandigarhDepartment of Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research, ChandigarhDepartment of Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research, ChandigarhDepartment of Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research, ChandigarhLymph nodal (LN) metastasis is the most important prognostic factor in high-risk endometrial cancer. However, the benefit of routine lymphadenectomy in endometrial cancer is controversial. This study was conducted to assess the accuracy of [ 18 F] fluorodeoxyglucose-positron emission tomography/computed tomography ([ 18 F] FDG-PET/CT) in detection of pelvic and para-aortic nodal metastases in high-risk endometrial cancer. 20 patients with high-risk endometrial carcinoma underwent [ 18 F] FDG-PET/CT followed by total abdominal hysterectomy, bilateral salpingo-oophorectomy and systematic pelvic lymphadenectomy with or without para-aortic lymphadenectomy. The findings on histopathology were compared with [ 18 F] FDG-PET/CT findings to calculate the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of [ 18 F] FDG-PET/CT. The pelvic nodal findings were analyzed on a patient and nodal chain based criteria. The para-aortic nodal findings were reported separately. Histopathology documented nodal involvement in two patients (10%). For detection of pelvic nodes, on a patient based analysis, [ 18 F] FDG-PET/CT had a sensitivity of 100%, specificity of 61.11%, PPV of 22.22%, NPV of 100% and accuracy of 65% and on a nodal chain based analysis, [ 18 F] FDG-PET/CT had a sensitivity of 100%, specificity of 80%, PPV of 20%, NPV of 100%, and accuracy of 80.95%. For detection of para-aortic nodes, [ 18 F] FDG-PET/CT had sensitivity of 100%, specificity of 66.67%, PPV of 20%, NPV of 100%, and accuracy of 69.23%. Although [ 18 F] FDG-PET/CT has high sensitivity for detection of LN metastasis in endometrial carcinoma, it had moderate accuracy and high false positivity. However, the high NPV is important in selecting patients in whom lymphadenectomy may be omitted.http://www.thieme-connect.de/DOI/DOI?10.4103/1450-1147.144817[ 18 f] fluorodeoxyglucose-positron emission tomography/computed tomographyendometrial cancerhigh risklymphadenectomypreoperative imaging |
| spellingShingle | Nikhil Gholkar Subhas Saha GRV Prasad Anish Bhattacharya Radhika Srinivasan Vanita Suri The accuracy of integrated [ 18 F] fluorodeoxyglucose-positron emission tomography/computed tomography in detection of pelvic and para-aortic nodal metastasis in patients with high risk endometrial cancer World Journal of Nuclear Medicine [ 18 f] fluorodeoxyglucose-positron emission tomography/computed tomography endometrial cancer high risk lymphadenectomy preoperative imaging |
| title | The accuracy of integrated [ 18 F] fluorodeoxyglucose-positron emission tomography/computed tomography in detection of pelvic and para-aortic nodal metastasis in patients with high risk endometrial cancer |
| title_full | The accuracy of integrated [ 18 F] fluorodeoxyglucose-positron emission tomography/computed tomography in detection of pelvic and para-aortic nodal metastasis in patients with high risk endometrial cancer |
| title_fullStr | The accuracy of integrated [ 18 F] fluorodeoxyglucose-positron emission tomography/computed tomography in detection of pelvic and para-aortic nodal metastasis in patients with high risk endometrial cancer |
| title_full_unstemmed | The accuracy of integrated [ 18 F] fluorodeoxyglucose-positron emission tomography/computed tomography in detection of pelvic and para-aortic nodal metastasis in patients with high risk endometrial cancer |
| title_short | The accuracy of integrated [ 18 F] fluorodeoxyglucose-positron emission tomography/computed tomography in detection of pelvic and para-aortic nodal metastasis in patients with high risk endometrial cancer |
| title_sort | accuracy of integrated 18 f fluorodeoxyglucose positron emission tomography computed tomography in detection of pelvic and para aortic nodal metastasis in patients with high risk endometrial cancer |
| topic | [ 18 f] fluorodeoxyglucose-positron emission tomography/computed tomography endometrial cancer high risk lymphadenectomy preoperative imaging |
| url | http://www.thieme-connect.de/DOI/DOI?10.4103/1450-1147.144817 |
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