Detecting para-aortic lymph nodal metastasis by positron emission tomography of 18F-fluorodeoxyglucose in advanced cervical cancer with negative magnetic resonance imaging findings

Abstract

The patient's prognosis is significantly related to para-aortic lymph node metastasis in advanced cervical cancer. Magnetic resonance imaging (MRI) has been widely performed to detect lymph node metastasis with a variable sensitivity. Therefore, in this prospective study, we evaluated FDG-PET to detec para-aortic lymph nodal metastasis in locally advanced cervical carcinoma with negative MRI findings. Forty-two women with advanced cervical cancer and negative abdominal MRI findings were included in this study. Para-aortic lymph node metastases were confirmed according to para-aortic lymph-adenectomy findings. Para-aortic lymphadenectomy findings showed 12 patients with para-aortic lymph nodal metastasis. Two patients had false-negative and 1 patient had false-positive FDG-PET findings. The FDG-PET showed sensitivity of 83.3%, specificity of 96.7%, and accuracy of 92.9%. As assessment of para-aortic lymph node metastases may be essential for therapy planning, FDG-PET is an alternative tool to detect para-aortic lymph node metastases in advanced cervical cancer with negative MRI findings.