[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

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

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

Oncol Lett. 2018 Mar;15(3):3951-3956. doi: 10.3892/ol.2018.7775. Epub 2018 Jan 12.

Authors

Philip Anner¹, Marius Mayerhöfer², Wolfgang Wadsak¹, Silvana Geleff³, Robert Dudczak¹, Alexander Haug¹, Marcus Hacker¹, Georgios Karanikas¹

Affiliations

¹ Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, A-1090 Vienna, Austria.
² Department of Biomedical Imaging and Image-guided Therapy, Division of General and Pediatric Radiology, Medical University of Vienna, A-1090 Vienna, Austria.
³ Department of Pathology, Medical University of Vienna, A-1090 Vienna, Austria.

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.

Keywords: 18F-fludeoxyglucose positron emission tomography/computed tomography; cervical carcinoma; magnetic resonance imaging; pelvic nodal staging; positron emission tomography/magnetic resonance imaging.