Diagnostic Accuracy of FEC-PET/CT, FDG-PET/CT, and Diffusion-Weighted MRI in Detection of Nodal Metastases in Surgically Treated Endometrial and Cervical Carcinoma
| Autor: | Gary Cook, William R. Wilson, Pierre L. Martin-Hirsch, Naveena Singh, Sudha Sundar, Tara Barwick, Andrea Rockall, Dow-Mu Koh, Katja N. De Paepe, Christina Fotopoulou, Marielle Nobbenhuis, Victoria Warbey, Nishat Bharwani, Anju Sahdev, Aslam Sohaib, Marc E. Miquel, Helen F. Stringfellow, Allan Hackshaw, Ranjit Manchanda, Sadaf Ghaem-Maghami |
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| Přispěvatelé: | Imperial College Healthcare NHS Trust- BRC Funding |
| Rok vydání: | 2021 |
| Předmět: |
Cancer Research
Uterine Cervical Neoplasms Surgical planning Fluorodeoxyglucose F18 TOMOGRAPHY Positron Emission Tomography Computed Tomography Medicine Humans 1112 Oncology and Carcinogenesis Oncology & Carcinogenesis Prospective Studies Stage (cooking) Neoplasm Staging Cervical cancer UTILITY PET-CT Science & Technology IDENTIFICATION business.industry Endometrial cancer medicine.disease TUMORS Magnetic Resonance Imaging LYMPHADENECTOMY PROSTATE-CANCER Diffusion Magnetic Resonance Imaging Oncology MAPPING Study Group Positron-Emission Tomography Female False positive rate Radiopharmaceuticals Nuclear medicine business NODAL Tomography X-Ray Computed Life Sciences & Biomedicine Diffusion MRI CT |
| Zdroj: | Clinical cancer research : an official journal of the American Association for Cancer Research. 27(23) |
| ISSN: | 1557-3265 |
| Popis: | Purpose: Preoperative nodal staging is important for planning treatment in cervical cancer and endometrial cancer, but remains challenging. We compare nodal staging accuracy of 18F-ethyl-choline-(FEC)-PET/CT, 18F-fluoro-deoxy-glucose-(FDG)-PET/CT, and diffusion-weighted-MRI (DW-MRI) with conventional morphologic MRI. Experimental Design: A prospective, multicenter observational study of diagnostic accuracy for nodal metastases was undertaken in 5 gyne-oncology centers. FEC-PET/CT, FDG-PET/CT, and DW-MRI were compared with nodal size and morphology on MRI. Reference standard was strictly correlated nodal histology. Eligibility included operable cervical cancer stage ≥ 1B1 or endometrial cancer (grade 3 any stage with myometrial invasion or grade 1–2 stage ≥ II). Results: Among 162 consenting participants, 136 underwent study DW-MRI and FDG-PET/CT and 60 underwent FEC-PET/CT. In 118 patients, 267 nodal regions were strictly correlated at histology (nodal positivity rate, 25%). Sensitivity per patient (n = 118) for nodal size, morphology, DW-MRI, FDG- and FEC-PET/CT was 40%*, 53%, 53%, 63%*, and 67% for all cases (*, P = 0.016); 10%, 10%, 20%, 30%, and 25% in cervical cancer (n = 40); 65%, 75%, 70%, 80% and 88% in endometrial cancer (n = 78). FDG-PET/CT outperformed nodal size (P = 0.006) and size ratio (P = 0.04) for per-region sensitivity. False positive rates were all Conclusions: All imaging techniques had low sensitivity for detection of nodal metastases and cannot replace surgical nodal staging. The performance of FEC-PET/CT was not statistically different from other techniques that are more widely available. FDG-PET/CT had higher sensitivity than size in detecting nodal metastases. False positive rates were low across all methods. The low false positive rate demonstrated by FDG-PET/CT may be helpful in arbitration of challenging surgical planning decisions. |
| Databáze: | OpenAIRE |
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