Preoperative Positron-Emision Tomography/Computed Tomography Findings in Endometrial Cancer: A Study of 30 Cases

Abstract

Objective: The aim of this study was to find out if preoperative PET/CT could be a substitute for staging surgery and whether SUVmax values correlate with prognostic factors of endometrium cancer.
Study Design: 30 patients to whom18-fluorodeoxyglucose PET/CT scan was performed preoperatively were analyzed retrospectively. Standardized uptake value (SUV) was calculated on PET images. PET findings were compared with surgical and pathological findings.
Results: SUVmax of the endometrioid type tumors were significantly higher than non-endometrioid types (p: 0.042). SUVmax significantly differ between histologic grades (p: 0.042). SUVmax did not differ between patients who had myometrial invasion less or more than 50% and who had lymphovascular invasion or not. There was not a significant difference between SUVmax and FIGO stages also. Possibility of extra-uterine lesion in PET/CT were significantly higher in late stages (p: 0.004). Sensitivity and specificity of PET/CT for detection of beyond stage 1 disease were 50% and 67% respectively and sensitivity and specificity of PET/CT for detection of lymph node metastasis were 40% and 86% respectively.
Conclusion: PET/CT has moderate sensitivity for pre-operative detection of beyond stage 1 cancers but it has a high specificity and low-moderate sensitivity for detection of lymph node metastasis but has high specificity. Because the positive likelihood ratios are relatively low, PET/CT cannot be a substitute for staging surgery.