MRI, PET/CT and ultrasound in the preoperative staging of endometrial cancer - A multicenter prospective comparative study

被引：170

作者：

Antonsen, Sofie Leisby ^{[1
]}

Jensen, Lisa Neerup ^{[2
]}

Loft, Annika ^{[3
]}

Berthelsen, Anne Kiil ^{[3
]}

Costa, Junia ^{[3
]}

Tabor, Ann ^{[2
,16
]}

Qvist, Ingelise ^{[4
]}

Hansen, Mette Rodi ^{[5
]}

Fisker, Rune ^{[6
]}

Andersen, Erik Sogaard ^{[7
]}

Sperling, Lene ^{[8
]}

Nielsen, Anne Lerberg ^{[9
]}

Asmussen, Jon ^{[10
]}

Hogdall, Estrid ^{[11
]}

Fago-Olsen, Carsten L. ^{[1
]}

Christensen, Ib Jarle ^{[12
,13
]}

Nedergaard, Lotte ^{[14
]}

Jochumsen, Kirsten ^{[15
]}

Hogdall, Claus ^{[16
]}

机构：

[1] Copenhagen Univ Hosp, Rigshosp, Gynecol Clin, DK-2100 Copenhagen O, Denmark

[2] Copenhagen Univ Hosp, Rigshosp, Ctr Fetal Med & Ultrasound, DK-2100 Copenhagen O, Denmark

[3] Copenhagen Univ Hosp, Rigshosp, Dept Clin Physiol Nucl Med & PET, DK-2100 Copenhagen O, Denmark

[4] Aalborg Univ Hosp, Dept Ultrasound, DK-9100 Aalborg, Denmark

[5] Aalborg Univ Hosp, Dept Radiol, DK-9100 Aalborg, Denmark

[6] Aalborg Univ Hosp, Dept Nucl Med, DK-9100 Aalborg, Denmark

[7] Aalborg Univ Hosp, Dept Gynecol & Obstet, DK-9100 Aalborg, Denmark

[8] Odense Univ Hosp, Dept Fetal Med, DK-5000 Odense C, Denmark

[9] Odense Univ Hosp, Dept Nucl Med, DK-5000 Odense C, Denmark

[10] Odense Univ Hosp, Dept Radiol, DK-5000 Odense C, Denmark

[11] Herlev Univ Hosp, Danish CancerBiobank, Dept Pathol, DK-2730 Herlev, Denmark

[12] Univ Copenhagen, Rigshosp, Finsen Lab, DK-2200 Copenhagen, Denmark

[13] Univ Copenhagen, BRIC, DK-2200 Copenhagen, Denmark

[14] Copenhagen Univ Hosp, Rigshosp, Dept Pathol, DK-2100 Copenhagen O, Denmark

[15] Odense Univ Hosp, Dept Gynecol & Obstet, DK-5000 Odense C, Denmark

[16] Univ Copenhagen, Fac Hlth Sci, DK-2200 Copenhagen N, Denmark

来源：

GYNECOLOGIC ONCOLOGY | 2013年 / 128卷 / 02期

关键词：

Endometrial cancer; Preoperative staging; PET/CT; MRI; Transvaginal ultrasound; LYMPH-NODE METASTASIS; ASSESSING MYOMETRIAL INVASION; TRANSVAGINAL SONOGRAPHY; CERVICAL INVASION; FDG-PET; CARCINOMA; ULTRASONOGRAPHY; ACCURACY; INFILTRATION; TOMOGRAPHY;

D O I：

10.1016/j.ygyno.2012.11.025

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Objectives. The aim of this prospective multicenter study was to evaluate and compare the diagnostic performance of PET/CT, MRI and transvaginal two-dimensional ultrasound (2DUS) in the preoperative assessment of endometrial cancer (EC). Methods. 318 consecutive women with EC were included when referred to three Danish tertiary gynecological centers for surgical treatment. Preoperatively they were PET/CT-, MRI-, and 2DUS scanned. The imaging results were compared to the final pathological findings. This study was approved by the National Committee on Health Research Ethics. Results. For predicting myometrial invasion, we found sensitivity, specificity, PPV, NPV, and accuracy for PET/CT to be 93%, 49%, 41%, 95% and 61%, for MRI to be 87%, 57%, 44%, 92%, and 66% and for 2DUS to be 71%, 72%, 51%, 86% and 72%. For predicting cervical invasion, the values were 43%, 94%, 69%, 85% and 83%, respectively, for PET/CT, 33%, 95%, 60%, 85%, and 82%, respectively, for MRI, and 29%, 92%, 48%, 82% and 78% for 2DUS. Finally, for lymph node metastases, the values were 74%, 93%, 59%, 96%, and 91% for PET/CT and 59%, 93%, 40%, 97% and 90% for MRI. When comparing the diagnostic performance we found PET/CT, MRI and 2DUS to be comparable in predicting myometrial invasion. For cervical invasion and lymph node metastases, however, PET/CT was the best. Conclusions. None of the modalities can yet replace surgical staging. However, they all contributed to important knowledge and were, furthermore, able to upstage low-risk patients who would not have been recommended lymph node resection based on histology and grade alone. (c) 2012 Elsevier Inc. All rights reserved.

引用

页码：300 / 308

页数：9

共 37 条

[1] Preoperative assessment of myometrial and cervical invasion in endometrial carcinoma by transvaginal ultrasound [J].