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The Value of Preoperative Positron Emission Tomography/Computed Tomography in Node-Negative Endometrial Cancer on Magnetic Resonance Imaging

  • Gynecologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Objective

The aim of this study was to investigate the value of [18F]fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) in predicting lymph node status in node-negative endometrial cancer on preoperative magnetic resonance imaging (MRI).

Methods

Patients with endometrial cancer who underwent both preoperative MRI and FDG-PET/CT followed by hysterectomy and lymphadenectomy were initially included. We then enrolled patients with MRI-defined node-negative disease (lymph nodes <1 cm in the short-axis diameter, or no visible lymph node). Histologic examination was the gold standard for lymph node metastasis diagnosis. The diagnostic performance of FDG-PET/CT in predicting lymph node metastasis was calculated in patient-by-patient and lymph node station-by-station analyses.

Results

On preoperative MRI, 362 patients had no lymph node metastasis. All patients underwent pelvic lymph node dissection and 118 patients underwent further para-aortic lymph node dissection. From 2099 lymph node stations, 10,238 lymph nodes were retrieved. Twenty-seven patients (7.5%) had lymph node metastasis in 49 lymph node stations (2.3%) on pathologic examination. FDG-PET/CT identified lymph node metastasis in five patients (18.5%) and eight lymph node stations (16.3%). The median diameter of false-negative metastatic lymph nodes was 6 mm (range 1–22) in the long axis and 3 mm (range 1–11) in the short axis. For para-aortic lymph nodes, FDG-PET/CT diagnosed 2 of 11 patients (18.1%) with para-aortic lymph node metastasis, and 3 of 12 para-aortic lymph node stations (25%) with metastasis.

Conclusion

Preoperative FDG-PET/CT has low value in predicting lymph node metastasis in node-negative endometrial cancer on preoperative MRI.

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Disclosures

Jeong-Yeol Park, Jong Jin Lee, Hyuck Jae Choi, In Hye Song, Chang Ohk Sung, Hye Ok Kim, Sun-Young Chae, Young-Tak Kim, and Joo-Hyun Nam declare that there are no conflicts of interest.

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Author notes

  1. Jeong-Yeol Park and Jong Jin Lee contributed equally as the first authors of this work.

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Jeong-Yeol Park MD, PhD, Young-Tak Kim MD, PhD & Joo-Hyun Nam MD, PhD

  2. Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Jong Jin Lee MD, Hye Ok Kim MD & Sun-Young Chae MD

  3. Department of Radiology, Kangwon National University Hospital, Chuncheon, Korea

    Hyuck Jae Choi MD, PhD

  4. Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    In Hye Song MD & Chang Ohk Sung MD

Authors
  1. Jeong-Yeol Park MD, PhD
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  2. Jong Jin Lee MD
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  3. Hyuck Jae Choi MD, PhD
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  4. In Hye Song MD
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  8. Young-Tak Kim MD, PhD
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  9. Joo-Hyun Nam MD, PhD
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Corresponding authors

Correspondence to Jeong-Yeol Park MD, PhD or Hyuck Jae Choi MD, PhD.

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Park, JY., Lee, J.J., Choi, H.J. et al. The Value of Preoperative Positron Emission Tomography/Computed Tomography in Node-Negative Endometrial Cancer on Magnetic Resonance Imaging. Ann Surg Oncol 24, 2303–2310 (2017). https://doi.org/10.1245/s10434-017-5901-8

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  • DOI: https://doi.org/10.1245/s10434-017-5901-8

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