PET/CT 扫描与单独 CT 扫描相比，可提高高级别神经内分泌宫颈癌女性转移性疾病的检出率：一项 NeCTuR 研究。

PET/CT scan improves detection of metastatic disease compared with CT scan alone in women with high-grade neuroendocrine cervical cancer: a NeCTuR study.

机构信息

Department of Gynecologic Oncology and Reproductive Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA

Department of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

出版信息

Int J Gynecol Cancer. 2023 Nov 6;33(11):1690-1694. doi: 10.1136/ijgc-2023-004907.

DOI:10.1136/ijgc-2023-004907

PMID:37875320

Abstract

OBJECTIVE

To determine the optimal imaging modality for women with high-grade neuroendocrine carcinoma of the cervix.

METHODS

Women with high-grade neuroendocrine carcinoma of the cervix who had undergone a computed tomography (CT) scan and combined positron emission tomography with computed tomography (PET/CT) scan within 4 weeks of each other were identified from the NeCTuR Cervical Tumor Registry. One radiologist reviewed all CT scans, and another radiologist reviewed all PET/CT scans. The radiologists denoted the presence or absence of disease at multiple sites. Each radiologist was blinded to prior reports, patient outcomes, and the readings of the other radiologist. With findings on PET/CT used as the gold standard, sensitivity, specificity, and accuracy were calculated for CT scans.

RESULTS

Fifty matched CT and PET/CT scans were performed in 41 patients. For detecting primary disease in the cervix, CT scan had a sensitivity of 85%, a specificity of 46%, and an accuracy of 74%. For detecting disease spread to the liver, CT scan had a sensitivity of 80%, a specificity of 89%, and an accuracy of 86%. For detecting disease spread to the lung, CT had a sensitivity of 89%, a specificity of 68%, and an accuracy of 77%. Of the 14 patients who had scans for primary disease work-up, 4 (29%) had a change in their treatment plan due to the PET/CT scan. Had treatment been prescribed on the basis of the CT scan alone, 2 patients would have been undertreated, and 2 would have been overtreated.

CONCLUSION

A CT scan is inferior to a PET/CT scan in assessment of metastatic disease in women with high-grade neuroendocrine carcinoma of the cervix. Almost one-third of patients with newly diagnosed high-grade neuroendocrine cervical cancer would have received incorrect therapy had treatment planning been based solely on a CT scan. We recommend a PET/CT scan for both initial work-up and surveillance in women with high-grade neuroendocrine carcinoma of the cervix.

摘要

目的

确定用于诊断宫颈高级别神经内分泌癌的最佳影像学方法。

方法

从 NeCTuR 宫颈肿瘤登记处中确定了在彼此 4 周内接受过计算机断层扫描（CT）和正电子发射断层扫描（PET）联合 CT 扫描（PET/CT）的宫颈高级别神经内分泌癌女性患者。一位放射科医生审查了所有 CT 扫描，另一位放射科医生审查了所有 PET/CT 扫描。放射科医生在多个部位表示疾病的存在或不存在。每位放射科医生都对之前的报告、患者结局和另一位放射科医生的阅读结果不知情。以 PET/CT 的检查结果为金标准，计算 CT 扫描的敏感性、特异性和准确性。

结果

在 41 名患者中进行了 50 次匹配的 CT 和 PET/CT 扫描。对于检测宫颈原发疾病，CT 扫描的敏感性为 85%，特异性为 46%，准确性为 74%。对于检测肝脏转移疾病，CT 扫描的敏感性为 80%，特异性为 89%，准确性为 86%。对于检测肺部转移疾病，CT 扫描的敏感性为 89%，特异性为 68%，准确性为 77%。在进行原发疾病检查的 14 名患者中，有 4 名（29%）因 PET/CT 扫描而改变了治疗计划。如果仅根据 CT 扫描进行治疗，有 2 名患者的治疗不足，有 2 名患者的治疗过度。