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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
Original Article

Abstract

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.

Keywords

Uterine carcinosarcoma 18F-Fluorodeoxyglucose Positron emission tomography Magnetic resonance imaging 

Notes

Compliance with Ethical Standards

Conflict of Interest

Won Jun Kang declares that this research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI17C1491) and the National Research Foundation of Korea(NRF) grant funded by the Korea government(MSIT) (No. 2018004651). Soyoung Kim, Young Tae Kim, Sunghoon Kim, Sang Wun Kim, and Jung-Yun Lee declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

The institutional review board of our institute approved this retrospective study, and the requirement to obtain informed consent was waived.

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Copyright information

© Korean Society of Nuclear Medicine 2018

Authors and Affiliations

  • Soyoung Kim
    • 1
  • Young Tae Kim
    • 2
  • Sunghoon Kim
    • 2
  • Sang Wun Kim
    • 2
  • Jung-Yun Lee
    • 2
  • Won Jun Kang
    • 1
  1. 1.Department of Nuclear Medicine, Severance HospitalYonsei University College of MedicineSeoulSouth Korea
  2. 2.Department of Obstetrics and Gynecology, Severance HospitalYonsei University College of MedicineSeoulSouth Korea

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