The value of PET/CT in determining lymph node metastasis of endometrial cancer

Objectives: In our study, the role of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) in determining lymph node metastasis of endometrial cancer was evaluated. Material and methods: The present retrospectively registered study included 80 patients with endometrial cancer who underwent PET/CT in preoperative period.The patients underwent total hysterectomy with bilateral sal pingo-oophorectomy and lymph node dissection. Lymph node status was evaluated in histopathologic examination and PET/CT imaging and, the results were compared. Results: There were 80 patients (mean age 62 years) in the present study. Lymph node metastasis was detected in five patients, whereas 75 patients had no lymph node metastasis. A total of 1,471 lymph nodes were examined histopathologically, revealing benign findings in 1,433 (pelvic = 1018, paraaortic= 415) and malignant findings in 38 (pelvic= 28, paraaortic = 10) lymph nodes. The accuracy, sensitivity and specificity of PET/CT in determining lymph node metastasis was 95%, 80% and 96% in patient-based evaluation, and 97.4%, 78.9% and 98.6% in lymph node-based evaluation, respectively. The detection sensitivity of PET/CT was 0%, 81.4% and 100% in metastatic lymph nodes with a short diameter of <= 4 mm, 5-9 mm and >= 10 mm, respectively. PET/CT could detect 73.3% of metastatic lymph nodes that had < 10 mm short diameter. Conclusions: PET/CT is useful method in detecting lymph node metastasis especially that are disregarded by CT or MR in endometrial cancer. Although PET/CT doesn't fully replace the surgical staging, its utilization in preoperative period may guide surgical procedure.