Utility of PET/CT to evaluate retroperitoneal lymph node metastasis in high-risk endometrial cancer: Results of ACRIN 6671/GOG 0233 trial

Mostafa Atri, Zheng Zhang, Farrokh Dehdashti, Susanna I. Lee, Helga Marques, Shamshad Ali, Wui Jin Koh, Robert S. Mannel, Paul DiSilvestro, Stephanie A. King, Michael Pearl, Xun Clare Zhou, Marie Plante, Katherine M. Moxley, Michael Gold

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

Purpose: To assess the diagnostic accuracy of fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) combined with diagnostic contrast material-enhanced computed tomography (CT) in detecting lymph node (LN) metastasis in high-risk endometrial cancer. Materials and Methods: This prospective multicenter HIPAA-compliant study had institutional review board approval, and all participants gave written informed consent. Data were accrued between January 2010 and June 2013. Patients underwent PET/CT and pelvic and abdominal lymphadenectomy. Two hundred seven of 215 enrolled patients had PET/CT and pathologic examination results for the abdomen and pelvis. Mean patient age was 62.7 years 6 9.6 (standard deviation). Data in all 23 patients with a positive abdominal examination and in 26 randomly selected patients with a negative abdominal examination were used for this central reader study. Seven independent blinded readers reviewed diagnostic CT and PET/CT results in different sessions 1 month apart. Accuracy was calculated at the participant level, correlating abdominal (right and left para-aortic and common iliac) and pelvic (right and left external iliac and obturator) LN regions with pathologic results, respecting laterality. Readeraverage sensitivities, specificities, and areas under the receiver operating characteristic curve (AUCs) of PET/CT and diagnostic CT were compared. Power calculation was for sensitivity and specificity in the abdomen. Results: Sensitivities of PET/CT versus diagnostic CT for the detection of LN metastasis were 0.65 (95% confidence interval [CI]: 0.57, 0.72) versus 0.50 (95% CI: 0.43, 0.58) (P = .01) in the abdomen and 0.65 (95% CI: 0.57, 0.72) versus 0.48 (95% CI: 0.41, 0.56) (P = .004) in the pelvis. Corresponding specificities were 0.88 (95% CI: 0.83, 0.92) versus 0.93 (95% CI: 0.89, 0.96) (P = .11) and 0.93 (95% CI: 0.86, 0.96) versus 0.89 (95% CI: 0.82, 0.94) (P = .27), and AUCs were 0.78 (95% CI: 0.66, 0.89) versus 0.74 (95% CI: 0.63, 0.86) (P = .39) and 0.82 (95% CI: 0.71, 0.92) versus 0.73 (95% CI: 0.63, 0.84) (P = .02). Conclusion: FDG PET/CT has satisfactory diagnostic accuracy in the detection of abdominal LN metastasis in high-risk endometrial cancer. Compared with diagnostic CT alone, addition of PET to diagnostic CT significantly increased sensitivity in both the abdomen and pelvis while maintaining high specificity.

Original languageEnglish
Pages (from-to)450-459
Number of pages10
JournalRadiology
Volume283
Issue number2
DOIs
StatePublished - May 2017

Fingerprint Dive into the research topics of 'Utility of PET/CT to evaluate retroperitoneal lymph node metastasis in high-risk endometrial cancer: Results of ACRIN 6671/GOG 0233 trial'. Together they form a unique fingerprint.

  • Cite this

    Atri, M., Zhang, Z., Dehdashti, F., Lee, S. I., Marques, H., Ali, S., Koh, W. J., Mannel, R. S., DiSilvestro, P., King, S. A., Pearl, M., Zhou, X. C., Plante, M., Moxley, K. M., & Gold, M. (2017). Utility of PET/CT to evaluate retroperitoneal lymph node metastasis in high-risk endometrial cancer: Results of ACRIN 6671/GOG 0233 trial. Radiology, 283(2), 450-459. https://doi.org/10.1148/radiol.2016160200