Evaluation of lymph node metastasis in cervical cancer: A retrospective comparison of preoperative MRI and PET/CT with postoperative histopathology results.

OBJECTIVE

The aim of this study is to assess the diagnostic performance of positron emission tomography/computed tomography (PET/CT) and magnetic resonance imaging (MRI) in detecting pelvic and paraaortic lymph node involvement in cervical cancer patients by correlating imaging results with surgical pathology findings.

MATERIALS AND METHODS

A retrospective analysis was conducted on cervical cancer patients treated at İstanbul Medeniyet University Prof. Dr. Süleyman Yalçın City Hospital from 2016 to 2022. Patients who underwent preoperative PET/CT or MRI imaging and subsequent lymph node dissection were included. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated for each imaging modality.

RESULTS

Of the 75 cases reviewed, 52 met the inclusion criteria. PET/CT had higher specificity (94.1%) than MRI (82.4%), while MRI demonstrated greater sensitivity (55.6% vs. 50%). False-negative rates were 15.3% for MRI and 17.3% for PET/CT. Receiver operating characteristic analysis indicated an area under the curve of 0.78 for PET/CT and 0.69 for MRI. No statistically significant differences in sensitivity or specificity were observed, with both modalities showing complementary strengths.

CONCLUSION

MRI and PET/CT each contribute significantly to preoperative cervical cancer evaluation, with MRI favored for local assessment and PET/CT for nodal detection. Combining both modalities enhances diagnostic accuracy. Further prospective research is required to confirm and strengthen these results. and improve imaging strategies for clinical practice.