Diagnostic PET/CT for detecting malignant lymph nodes in patients with cervical cancer Stage IB1

Background: After initial diagnosis of cervical cancer, patients are staged and clinically evaluated with PET/CT in order to assess disease extent. Patients with Stage IB1 disease usually undergo definitive surgery. The present authors’ objective was to evaluate the diagnostic value of PET/CT in cervical cancer Stage IB1. Materials and Methods: By searching the Danish Gynecological Database (DGCD) the authors identified 144 patients treated for cervical cancer Stage IB1 from 2012-2015 at Rigshospitalet, University Hospital Copenhagen, Denmark. Patients who underwent a PET/CT scan and either definitive surgery or diagnostic laparoscopy were included for further analysis. Results: One hundred forty patients had a PET/CT scan and results were available for 136 patients, six of which had suspicious lymph nodes; three patients did not have metastases and three patients did. One hundred thirty patients did not have sus-picious lymph nodes on PET/CT. Histological results were available for 106 of these patients and 97 of these did not have metastases and nine patients did. Out of all the 12 patients with metastatic lymph nodes, 11 had pelvic, none had para-aortic disease, and data re-garding localization was missing for the last patient. Regarding PET/CT detection of pelvic lymph nodes, the sensitivity was 25%, specificity 97%, positive predictive value 50%, and negative predictive value 92%. Conclusion: The sensitivity and positive predictive value of PET/CT in cervical cancer Stage IB1 patients were low. PET/CT cannot replace surgical lymphadenectomy and histologic ex-amination in these patients.

Cervical cancer; Stage Ib1; PET/CT; Sensitivity and positive predictive value of PET/CT.

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