Endometrial kanserde preoperatif lenf nodu metastazi tespiti: Endometrial kanserde 18-FDG PET/BT'nin rolü

Abstract

Amaç: Fluorine-18 2-floro-2-deoksi-D-glukoz (FDG) pozitron emisyon tomografisi (PET)/ BT görüntüleme tekniği, lokalizasyonun ve fonksiyonel görüntülemenin avantajlarını birleştirdiğinden, endometrial kanserli hastalarda lenf nodu (LN) metastazlarının tespiti için tercih edilen bir yöntem haline gelmiştir. Bu çalışmada 18F-FDG PET/BT görüntüleme sonuçlarının, endometrial kanserin lenf nodu metastazının belirlenmesindeki etkinliğini araştırmayı amaçladık. 

Yöntemler: Bu çalışma 2009-2015 yılları arasında yapılan retrospektif kohort bir çalışmadır. Çalışma grubu kliniğimize başvuran ve endometriyal kanser tanısı alan tüm kadınlardan (n=135) oluşmaktaydı. Çalışmaya, ameliyat öncesi 18F-FDG PET/BT çekilen ve LN diseksiyonu yapılan hastaları dahil edildi. Bu yöntemin lend nodu metastazını belirlemede etkinliği değerlendirildi. Değerlendirmeler ve karşılaştırmalar altın standard patolojik tanı yöntemleriyle yapıldı. 

Bulgular: Lenf nodu metastazlarının tanımlanmasında 18F-FDG PET/BT yönteminin %76 duyarlılık, %80 özgüllük, %46.34 pozitif prediktif değeri ve %93.62 negatif prediktif değeri gösterdiği bulundu. Genel tanısal doğruluk ise %79,26 idi.

Sonuç: Analizlerimiz, 18F-FDG PET/BT'nin, endometriyal kanser hastalarında lenf nodu metastazı açısından yüksek negatif prediktif değere sahip olduğunu ve bu hastalarda lenf nodu metastazı araştırmada uygulanabilir bir görüntüleme yöntemi olduğunu göstermiştir.

Keywords

• Endometrial kanser,Lenf nodu metastazı,18F-FDG-PET/BT,Prognoz

Preoperative detection of lymph node metastasis in endometrial cancer: The role of 18-FDG PET/CT

Abstract

Aim: Fluorine-18 2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET)/CT imaging technique combines the advantages of localization and functional imaging, and thus has become a preferred method for detection of metastases to the lymph nodes (LN) of patients with endometrial cancer. The aim of this study was to evaluate the efficacy of 18F-FDG PET/CT imaging results in the detection of metastasis of endometrial cancer to lymph nodes.

Methods: This is a retrospective cohort study conducted between 2009 and 2015. The study group consisted of females who were admitted to our clinic and diagnosed with endometrial cancer (n=135). We included patients who underwent LN dissection with pre-operative 18F-FDG PET / CT imaging, and evaluated the capability of this method in terms of its effectiveness in determining metastases to the lymph nodes. Assessments and comparisons were performed with gold-standard pathological methods. 

Results: The 18F-FDG PET/CT method for identification of lymph node metastases had a sensitivity of 76%, a specificity of 80%, a positive predictive value of 46.34% and a negative predictive value of 93.62%. The overall diagnostic accuracy was 79.26%.

Conclusion: Our analysis suggests that 18F-FDG PET/CT has a high negative predictive value with regards to lymph node metastasis in endometrial cancer and may be used effectively in evaluating lymph node metastasis in this cohort.

Keywords

• Endometrial cancer,Lymph node metastasis,18F- FDG-PET/CT,Ratio,Prognosis

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