Diagnostic Value of 18F-FDG PET/CT and MRI in the Preoperative Evaluation of Uterine Carcinosarcoma

다국어 초록 (Multilingual Abstract)

Purpose This study aimed to compare the diagnostic value of 18F-fluorodeoxyglucose positron emission tomography/computedtomography (FDG PET/CT) and magnetic resonance imaging (MRI) in the preoperative evaluation of uterine carcinosarcoma.
Methods Fifty-four women with pathologically confirmed uterine carcinosarcoma who underwent preoperative FDG PET/CTand MRI from June 2006 to November 2016 were included. Pathologic findings from primary tumor lesions, para-aortic andpelvic lymph node (LN) areas, and peritoneal seeding lesions were compared with the FDG PET/CT and MRI findings. Themaximum standardized uptake value (SUVmax) of the primary tumor and LN was obtained. The tumor-to-liver ratio (TLR) wascalculated by dividing the SUVmax of the primary tumor or LN by the mean SUVof the liver.
Results For detecting primary tumor lesions (n = 54), the sensitivity and accuracy of FDGPET/CT (53/54) andMRI (53/54) were98.2%. The sensitivity, specificity, and accuracy of FDG PET/CT versus MRI were as follows: 63.2% (12/19) versus 26.3%(5/19), 100% (35/35) versus 100% (35/35), and 87.0% versus 74.0%, respectively, for pelvic LN areas (p = 0.016); 85.7% (12/14) versus 42.9%(6/14), 90%(36/40) versus 97.5%(39/40), and 88.9%versus 83.3%, respectively, for para-aortic LN areas (p =0.004); and 59.4% (19/32) versus 50% (16/32), 100% (22/22) versus 100% (22/22), and 75.9% versus 70.4%, respectively, forperitoneal seeding lesions (p = 0.250). For distant metastasis, the sensitivity, specificity, and accuracy of FDG PET/CTwere 100(8/8), 97.8 (45/46), and 98.2%, respectively.
Conclusions FDG PET/CT showed superior diagnostic accuracy compared to MRI in detecting pelvic and para-aortic LNmetastasis in patients with uterine carcinosarcoma. Moreover, FDG PET/CT facilitated the identification of distant metastasis.

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