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

 Soyoung Kim  ;  Young Tae Kim  ;  Sunghoon Kim  ;  Sang Wun Kim  ;  Jung-Yun Lee  ;  Won Jun Kang 
 Nuclear Medicine and Molecular Imaging, Vol.52(6) : 445-452, 2018 
Journal Title
 Nuclear Medicine and Molecular Imaging 
Issue Date
18F-Fluorodeoxyglucose ; Magnetic resonance imaging ; Positron emission tomography ; Uterine carcinosarcoma
Purpose: This study aimed to compare the diagnostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (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/CT and MRI from June 2006 to November 2016 were included. Pathologic findings from primary tumor lesions, para-aortic and pelvic lymph node (LN) areas, and peritoneal seeding lesions were compared with the FDG PET/CT and MRI findings. The maximum standardized uptake value (SUVmax) of the primary tumor and LN was obtained. The tumor-to-liver ratio (TLR) was calculated by dividing the SUVmax of the primary tumor or LN by the mean SUV of the liver. Results: For detecting primary tumor lesions (n = 54), the sensitivity and accuracy of FDG PET/CT (53/54) and MRI (53/54) were 98.2%. 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, for peritoneal seeding lesions (p = 0.250). For distant metastasis, the sensitivity, specificity, and accuracy of FDG PET/CT were 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 LN metastasis in patients with uterine carcinosarcoma. Moreover, FDG PET/CT facilitated the identification of distant metastasis.
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1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
Yonsei Authors
강원준(Kang, Won Jun) ORCID logo https://orcid.org/0000-0002-2107-8160
김상운(Kim, Sang Wun) ORCID logo https://orcid.org/0000-0002-8342-8701
김성훈(Kim, Sung Hoon) ORCID logo https://orcid.org/0000-0002-1645-7473
김소영(Kim, Soyoung) ORCID logo https://orcid.org/0000-0002-6163-1434
김영태(Kim, Young Tae) ORCID logo https://orcid.org/0000-0002-7347-1052
이정윤(Lee, Jung-Yun) ORCID logo https://orcid.org/0000-0001-7948-1350
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