Chest computed tomography before evacuation of hydatidiform mole.

PURPOSE OF INVESTIGATION

To evaluate the usefulness of chest CT for assessing pulmonary micrometastasis in hydatidiform moles.

METHOD

We retrospectively evaluated 48 cases diagnosed with hydatidiform moles. We collected and compared data between the pulmonary micrometastatic and non-metastatic groups based on several factors. The non-parametric, Mann-Whitney, Kaplan-Meier and log-rank tests were used.

RESULTS

Of 14 patients who underwent chest CT at their initial evaluation, 57% had pulmonary micrometastasis. The time to remission of serum beta-hCG after evacuation, serum beta-hCG before evacuation and the largest diameter of the uterus were statistically significant. Persistent GTD developed in 38% of the metastatic group, but in only 25% of the nonmetastatic group. Micrometastasis was missed by chest X-ray in 64% of 11 patients suspected of having micrometastasis.

CONCLUSION

The chest X-ray was suspected of being ineffective in the diagnosis of pulmonary micrometastasis, but the use of chest CT should be considered during the initial evaluation of hydatidiform moles.