- Preoperative positron emission tomography (PET)/CT fails to detect the positive lymph nodes and metastatic disease in more than half the patients with high-risk endometrial cancer.
Why this matters
- Findings suggest that preoperative PET/CT is not a reliable primary tool for initial preoperative evaluation, staging, or surgical planning.
- Study of 108 patients with newly diagnosed high-risk endometrial cancer who underwent preoperative PET/CT followed by surgery during 2013-2016.
- Outcome: detection rates of positive lymph nodes and peritoneal disease.
- Funding: National Institutes of Health; National Cancer Institute SPORE in Uterine Cancer.
- On PET/CT, 19.4% of patients had extrauterine disease, 17% had positive lymph nodes, and 7% had peritoneal disease.
- 95% of the patients underwent pelvic and para-aortic lymphadenectomy.
- For lymph nodes and peritoneal disease, respectively, PET/CT showed:
- Sensitivity of 45.8% and 37.5%.
- Specificity of 91.1% and 97.8%.
- Positive predictive value of 61.1% and 75%.
- Negative predictive value of 84.7% and 90.0%, respectively.
- False-negative rate of 54.2% and 62.5%.
- Single-center study.