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Journal of ZheJiang University(Medical Science)  2017, Vol. 46 Issue (5): 517-522    DOI: 10.3785/j.issn.1008-9292.2017.10.11
    
Value of 18F-FDG PET-CT in detection of primary lesion and pelvic lymph node metastasis in FIGO stages ⅠA2-ⅡA cervical cancer
FU Liping, CHENG Aiping, SUN Meiling, WANG Xiaogang, FU Jianlan
Department of Nuclear Medicine, Zhejiang Provincial People's Hospital, Hangzhou 310014, China
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Abstract  

Objective: To assess the value of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography-CT (PET-CT) in detection of primary tumor and pelvic lymph node metastasis in International Federation of Gynecology and Obstetrics (FIGO) stages ⅠA2-ⅡA cervical cancer.Methods: The clinical data of 91 patients with FIGO stagesⅠA2-ⅡA cervical cancer were retrospectively analyzed. The sensitivity of 18F-FDG PET-CT in detection of cervical cancer was calculated. The long diameter, short diameter and SUVmax were compared between metastatic lymph nodes (MLN) and non-metastatic lymph nodes (NMLN). The optimal cut-off values of different indexes were determined by receiver operating characteristic (ROC) curve and area under curve (AUC), and the sensitivity, specificity and accuracy were calculated.Results: 18F-FDG PET-CT examinations were positive in 89 patients (89/91, 96.7%). The short diameters of NMLN and MLN were (6.50±2.31)mm and (4.21±1.49)mm(t=4.855, P<0.05); the SUVmax of NMLN and MLN were 4.56±3.34 and 1.92±1.41(t=31.685, P<0.05). ROC AUCs of the short diameter and SUVmax in diagnosis of metastatic lymph nodes were 0.802 and 0.861. Taken short diameter ≥ 5.05 mm and SUVmax ≥ 2.05 as cut-off values, the corresponding sensitivity, specificity and accuracy in diagnosis of metastatic lymph nodes were 85.0%, 93.0% and 86.8%, respectively.Conclusion: 18F-FDG PET-CT is sensitive to detect primary lesion and pelvic lymph node metastases in FIGO stages ⅠA2-Ⅱ A cervical cancer, and the highest diagnostic accuracy may be obtained by taking short diameter ≥ 5.05 mm and SUVmax ≥ 2.05 as the standard.



Key wordsFluorodeoxyglucose F18/diagnostic use      Lymphatic metastasis      Tomography,emission-computed/methods      Neoplasm recurrence,local      Pelvic neoplasms/radionuclide imaging      Tomography,X-ray computed/methods      Uterine cervical neoplasms/radionuclide imaging     
Received: 01 June 2017      Published: 25 October 2017
CLC:  R817.4  
  R737.33  
Cite this article:

FU Liping, CHENG Aiping, SUN Meiling, WANG Xiaogang, FU Jianlan. Value of 18F-FDG PET-CT in detection of primary lesion and pelvic lymph node metastasis in FIGO stages ⅠA2-ⅡA cervical cancer. Journal of ZheJiang University(Medical Science), 2017, 46(5): 517-522.

URL:

http://www.zjujournals.com/xueshu/med/10.3785/j.issn.1008-9292.2017.10.11     OR     http://www.zjujournals.com/xueshu/med/Y2017/V46/I5/517


PET-CT诊断ⅠA2~ⅡA期宫颈癌原发灶和盆腔淋巴结转移的价值

目的:探讨18F-氟脱氧葡萄糖PET-CT (18F-FDG PET-CT)在诊断国际妇产科联盟(FIGO)ⅠA2~ⅡA期宫颈癌原发灶和盆腔淋巴结转移中的临床价值。方法:回顾性分析91例FIGOⅠA2~ⅡA期宫颈癌患者的临床资料。计算PET-CT诊断宫颈癌原发灶的敏感度,并比较转移性淋巴结与非转移性淋巴结的长径、短径和最大标准摄取值(SUVmax)。通过受试者工作特征(ROC)曲线和曲线下面积(AUC)确定短径和SUVmax诊断淋巴结转移的最佳分界值,并计算其诊断盆腔淋巴结转移的敏感度、特异度和准确度。结果:91例宫颈癌患者中,PET-CT检查阳性89例,PET-CT诊断宫颈癌原发灶的敏感度为96.7%。转移性淋巴结和非转移性淋巴结的短径分别为(6.50±2.31) mm和(4.21±1.49) mm,SUVmax分别为4.56±3.34和1.92±1.41,组间比较差异有统计学意义(t=4.855和31.685,均P<0.05)。淋巴结短径和SUVmax诊断淋巴结转移的AUC分别为0.802和0.861,最佳分界值分别为5.5 mm和2.05。以短径≥ 5.5 mm且SUVmax ≥ 2.05为诊断标准,诊断单个淋巴结转移的敏感度为85.0%,特异度为93.0%,准确度为86.8%。结论:PET-CT诊断ⅠA2~ⅡA宫颈癌原发病灶的敏感度高,对盆腔淋巴结转移也具有较高的诊断价值,以短径≥ 5.5 mm且SUVmax ≥ 2.05作为转移性淋巴结诊断标准时准确性最高。


关键词: 氟脱氧葡萄糖F18/诊断应用,  淋巴转移,  X线计算机/方法,  体层摄影术,  发射型计算机/方法,  盆腔肿瘤/放射性核素显像,  体层摄影术,  局部,  肿瘤复发,  宫颈肿瘤/放射性核素显像 
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