Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia.
Clinical Center of University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina.
Medicina (Kaunas). 2024 Oct 26;60(11):1758. doi: 10.3390/medicina60111758.
: The primary objective of this study is to assess the effectiveness of 18F-FDG-PET-CT in preoperative staging of cervical cancer, focusing on determining surgical operability and exploring the correlation between its quantitative parameters and clinicopathological characteristics. : This retrospective study included 62 cervical cancer patients treated at the Department of Gynecology, Clinic for Operative Oncology at the Institute of Oncology Vojvodina between January 2016 and January 2020, where preoperative clinical examinations and 18F-FDG-PET-CT were performed to assess the extent of cancer, followed by intraoperative and pathohistological examinations of surgically removed specimens to provide a comprehensive evaluation. : The mean tumor size measured by 18F-FDG-PET-CT was slightly greater than that obtained through clinical examination (26.4 mm vs. 26.0 mm), with a strong linear correlation (r = 0.678, < 0.001) observed between the two measurement methods. The overall prediction accuracy of 18F-FDG-PET-CT for primary tumors is 88.7% (55/62) [sensitivity 86.8%, specificity 100.0%, PPV 100.0%, NPV 56.2%] and for intraoperative examination is 88.7% (55/62) [sensitivity 98.1%, specificity 33.3%, PPV 89.7%, NPV 75.0%]. The agreement with histopathological examination was good for 18F-FDG-PET-CT and moderate for intraoperative examination for primary tumors. Regarding lymph nodes, the overall prediction accuracy of 18F-FDG-PET-CT is 82.2% (51/62) [sensitivity 53.8%, specificity 89.8%, PPV 58.3%, NPV 88.8%] and for intraoperative examination 66.1% (41/62) [sensitivity 76.9%, specificity 63.3%, PPV 35.7%, NPV 91.2%]. The agreement with histopathological examination was moderate for 18F-FDG-PET-CT and poor for intraoperative examination for lymph node metastasis, highlighting that the overall accuracy of 18F-FDG-PET-CT (82.1%) was significantly higher than that of intraoperative examination (66.1%) ( = 0.002). : In conclusion, 18F-FDG-PET-CT provides high accuracy in detecting primary tumors and superior predictive value for lymph node metastases compared to intraoperative examination, highlighting the importance of incorporating this imaging modality into the preoperative evaluation process to enhance diagnostic precision and inform treatment decisions.
: 本研究的主要目的是评估 18F-FDG-PET-CT 在宫颈癌术前分期中的有效性，重点确定手术的可操作性，并探讨其定量参数与临床病理特征的相关性。 : 这项回顾性研究纳入了 2016 年 1 月至 2020 年 1 月在伏伊伏丁那肿瘤研究所手术肿瘤学临床诊所接受治疗的 62 例宫颈癌患者，术前进行临床检查和 18F-FDG-PET-CT 检查以评估癌症的范围，然后对手术切除标本进行术中及病理组织学检查，以提供全面评估。 : 18F-FDG-PET-CT 测量的肿瘤平均大小略大于临床检查（26.4 毫米比 26.0 毫米），两种测量方法之间存在很强的线性相关性（r=0.678，<0.001）。18F-FDG-PET-CT 对原发性肿瘤的总体预测准确率为 88.7%（55/62）[敏感度 86.8%，特异性 100.0%，PPV 100.0%，NPV 56.2%]，术中检查的准确率为 88.7%（55/62）[敏感度 98.1%，特异性 33.3%，PPV 89.7%，NPV 75.0%]。18F-FDG-PET-CT 与病理组织学检查的一致性较好，与术中检查的一致性为中等。关于淋巴结，18F-FDG-PET-CT 的总体预测准确率为 82.2%（51/62）[敏感度 53.8%，特异性 89.8%，PPV 58.3%，NPV 88.8%]，术中检查为 66.1%（41/62）[敏感度 76.9%，特异性 63.3%，PPV 35.7%，NPV 91.2%]。18F-FDG-PET-CT 与病理组织学检查的一致性为中等，与术中检查的一致性为差，提示淋巴结转移的总体准确性（82.1%）明显高于术中检查（66.1%）（=0.002）。 : 综上所述，18F-FDG-PET-CT 在检测原发性肿瘤方面具有较高的准确性，在预测淋巴结转移方面具有较高的预测价值，与术中检查相比，强调将这种成像方式纳入术前评估过程，以提高诊断精度并为治疗决策提供信息。
