Abstract
BackgroundThe objective of this study was to compare the diagnostic value of integrated PET/MRI with PET/CT for assessment of regional lymph node metastasis and deep myometrial invasion detection of endometrial cancer.MethodsEighty-one patients with biopsy-proven endometrial cancer underwent preoperative PET/CT (n = 37) and integrated PET/MRI (n = 44) for initial staging. The diagnostic performance of PET/CT and integrated PET/MRI for assessing the extent of the primary tumor and metastasis to the regional lymph nodes was evaluated by two experienced readers. Histopathological and follow-up imaging results were used as the gold standard. McNemar’s test was employed for statistical analysis.ResultsIntegrated PET/MRI and PET/CT both detected 100% of the primary tumors. Integrated PET/MRI proved significantly more sensitivity and specificity than PET/CT in regional lymph node metastasis detection (P = 0.015 and P < 0.001, respectively). The overall accuracy of myometrial invasion detection for PET/CT and Integrated PET/MRI was 45.9% and 81.8%, respectively. Integrated PET/MRI proved significantly more accurate than PET/CT (P < 0.001).ConclusionIntegrated PET/MRI, which complements the individual advantages of MRI and PET, is a valuable technique for the assessment of the lymph node metastasis and myometrial invasion in patients with endometrial cancer.
Highlights
Endometrial cancer is the sixth most common cancer in women worldwide and the most common gynaecological malignancy in developed countries (Torre et al, 2015)
PET/CT and Integrated PET/MRI examinations were successfully completed in 37 patients and 44 patients, respectively (Table 1)
According to the revised International Federation of Gynecology and Obstetrics (FIGO) criteria (Kitajima et al, 2009), the T stage was classified as pT1a in 18 patients (PET/CT) and 24 patients (Integrated PET/MRI), pT1b in five (PET/CT) and four (Integrated PET/MRI), pT2 in five (PET/CT) and two (Integrated PET/MRI), pT3 in 2 (PET/CT) and six (Integrated PET/MRI), and pT4 in one (PET/CT)
Summary
Endometrial cancer is the sixth most common cancer in women worldwide and the most common gynaecological malignancy in developed countries (Torre et al, 2015). Accurate imaging diagnosis plays an important role in the treatment and prognosis of patients with endometrial cancer (Tsai et al, 2003). The objective of this study was to compare the diagnostic value of integrated PET/MRI with PET/CT for assessment of regional lymph node metastasis and deep myometrial invasion detection of endometrial cancer. The diagnostic performance of PET/CT and integrated PET/MRI for assessing the extent of the primary tumor and metastasis to the regional lymph nodes was evaluated by two experienced readers. Integrated PET/MRI proved significantly more sensitivity and specificity than PET/CT in regional lymph node metastasis detection (P = 0.015 and P < 0.001, respectively). Integrated PET/MRI, which complements the individual advantages of MRI and PET, is a valuable technique for the assessment of the lymph node metastasis and myometrial invasion in patients with endometrial cancer
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