Department of Nuclear Medicine, University Hospital, Limoges, France.
Anticancer Res. 2011 Nov;31(11):3865-71.
To assess pelvic (P) and/or paraaortic (PA) lymph node (LN) involvement in patients with primary stage IA-IVA cervical cancer, (18)F-fluorodeoxyglucose (FDG)-PET, and MRI were compared with histological results.
Forty patients were prospectively evaluated. Twenty-eight patients underwent radio-chemotherapy (RT-CT) after initial staging and lymph node dissection (LND).
PLN metastases were present in 6/31 patients. Sensitivity, specificity, positive and negative predictive values (PPV, NPV) and accuracy in detecting PLN metastases were 67%, 84%, 50%, 91% and 81%, with MRI, and 33%, 92%, 50%, 85% and 81%, with FDG-PET. PALN metastases were present in 5/27 patients. Sensitivity, specificity, PPV, NPV and accuracy were 60%, 73%, 33%, 89% and 70% with MRI and 100%, 77%, 50%, 100% and 81% with FDG-PET in detecting PALN metastasis.
FDG-PET is less accurate than MRI for PLN, but more accurate for PALN; FDG-PET cannot replace PA surgical procedures, but could guide them.
为了评估原发性 IA-IVA 期宫颈癌患者的盆腔(P)和/或腹主动脉旁(PA)淋巴结(LN)受累情况,将(18)F-氟代脱氧葡萄糖(FDG)-PET 与组织学结果进行了比较。
40 例患者进行了前瞻性评估。28 例患者在初始分期和淋巴结清扫(LND)后接受了放化疗(RT-CT)。
31 例中有 6 例存在 PLN 转移。MRI 检测 PLN 转移的灵敏度、特异度、阳性预测值(PPV)、阴性预测值(NPV)和准确率分别为 67%、84%、50%、91%和 81%,而 FDG-PET 则分别为 33%、92%、50%、85%和 81%。27 例中有 5 例存在 PALN 转移。MRI 检测 PALN 转移的灵敏度、特异度、PPV、NPV 和准确率分别为 60%、73%、33%、89%和 70%,而 FDG-PET 则分别为 100%、77%、50%、100%和 81%。
FDG-PET 对 PLN 的准确性不如 MRI,但对 PALN 的准确性更高;FDG-PET 不能替代 PA 手术,但可指导手术。