[18F]FDG-PET/CT and MRI for initial pelvic lymph node staging in patients with cervical carcinoma: The potential usefulness of [18F]FDG-PET/MRI

Anner,Philip; Mayerhöfer,Marius; Wadsak,Wolfgang; Geleff,Silvana; Dudczak,Robert; Haug,Alexander; Hacker,Marcus; Karanikas,Georgios

doi:10.3892/ol.2018.7775

[18F]FDG-PET/CT and MRI for initial pelvic lymph node staging in patients with cervical carcinoma: The potential usefulness of [18F]FDG-PET/MRI

Authors:
- Philip Anner
- Marius Mayerhöfer
- Wolfgang Wadsak
- Silvana Geleff
- Robert Dudczak
- Alexander Haug
- Marcus Hacker
- Georgios Karanikas
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Affiliations: Department of Biomedical Imaging and Image‑guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, A‑1090 Vienna, Austria, Department of Biomedical Imaging and Image‑guided Therapy, Division of General and Pediatric Radiology, Medical University of Vienna, A‑1090 Vienna, Austria, Department of Pathology, Medical University of Vienna, A‑1090 Vienna, Austria
Published online on: January 12, 2018 https://doi.org/10.3892/ol.2018.7775
Pages: 3951-3956

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Abstract

The current study aimed to determine the optimum diagnostic imaging technique out of magnetic resonance imaging (MRI), 18F‑fludeoxyglucose positron emission tomography/computed tomography ([18F]FDG‑PET/CT, otherwise known as PET/CT) and [18F]FDG‑PET/MRI (otherwise known as PET/MRI) for the pelvic lymph node staging (N‑staging) of untreated cervical carcinoma (CC). A total of 27 patients were included in the present study. All patients had undergone pre‑treatment with PET/CT and MRI ≤45 days prior to undergoing a lymphadenectomy. The results from PET (separated from PET/CT), MRI and the statistically combined results of (virtual) PET/MRI were compared to those from histological analyses (the gold standard). A per‑patient‑based analysis of the detection of pelvic lymph node metastases indicated that PET/MRI had a sensitivity of 64%. The specificity of PET/CT and MRI were 69 and 62%, respectively. The positive predictive value (PPV) was 69 and 64% for PET/CT and MRI, respectively. The negative predictive value (NPV) was 64 and 62% for PET/CT and MRI, respectively. The sensitivity of the PET‑guided PET/MRI and the MRI‑guided PET/MRI was 64% for both. The specificity of the PET‑guided PET/MRI and the MRI‑guided PET/MRI was 77 and 62%, respectively. The PPV was 75% for PET‑guided PET/MRI and 64% for MRI‑guided PET/MRI, and the NPV was 67 and 62%, respectively. PET/CT and the virtual PET/MRI exhibited the same low sensitivity (64%). PET/MRI exhibited slightly better results than PET/CT regarding specificity (77 vs. 69%, respectively), PPV (75 vs. 69%, respectively) and NPV (67 vs. 64%, respectively). The results of the present study suggested that PET/CT and MRI are not optimal diagnostic modalities, and that PET/MRI does not necessarily lead to better results than PET/CT, in the pelvic N-staging of CC.

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