Bagcilar Medical Bulletin (Sep 2022)

Evaluation of the Efficacy of PET/CT in Gynecological Cancers: A Retrospective Study

  • Yücel Kaya,
  • Nedim Tokgözoğlu,
  • Gökhan Demirayak,
  • Veli Mihmanlı,
  • Damla Yasemin Yenliç Kaya,
  • Hamit Caner Uzun

DOI
https://doi.org/10.4274/BMB.galenos.2022.2022-02-014
Journal volume & issue
Vol. 7, no. 3
pp. 197 – 204

Abstract

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Objective:To evaluate the efficacy of preoperative positron emission tomography/computed tomography (PET/CT) to detect lymph node metastasis in gynecologic malignancies.Method:This study included a total of 78 patients who underwent surgery for gynecological cancer at the Gynecology and Obstetrics Clinic, University of Health Sciences Turkey, Prof. Dr. Cemil Taşcıoğlu City Hospital between January 2016 and November 2017. Data on age, menopausal status, clinical diagnoses, definitive pathology reports and PET/CT findings were obtained from the Hospital Information Management System and the patient files. The histological type and pelvic and/or paraaortic lymph node involvement status of the tumor based on a definitive pathology report, and the maximum standardized uptake value (SUVmax) values of the primary tumor and lymph nodes with pathological involvement in the PET/CT were recorded.Results:Of the 78 patients, 42 had endometrial cancer, 10 had uterine sarcoma, 14 had cervical cancer and 12 had ovarian cancer. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of PET/CT in predicting lymph node metastasis were 54.5%, 96.7%, 85.7%, 85.7%, and 85.7%, respectively, in patients with endometrial cancer; 100%, 89.9%, 90%, 50%, and 100%, respectively, in patients with uterine sarcoma; 0%, 92.3%, 85.7%, 0%, and 92.3%, respectively, in patients with cervical cancer; and 62.5%, 75%, 66.7%, 83.3%, and 50%, respectively, in patients with ovarian cancer. When all of the patients were assessed together, these values were found to be 57.1 %, 92.9%, 83.3%, 75%, and 85.4%, respectively.Conclusion:The highest diagnostic yield of PET/CT was obtained for uterine sarcoma. Furthermore, among the metabolic parameters, the mean SUVmax value was found to be associated with lymph node metastasis only in patients with ovarian cancer and was not predictive in other gynecologic malignancies.

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