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01-03-2019 | Original Article

Role of Positron Emission Tomography/Computed Tomography in Preoperative Assessment of Carcinoma Endometrium—a Retrospective Analysis

Authors: Rohini Kulkarni, Rani Akhil Bhat, Vibhawari Dhakharia, Kumar Kallur, Aparna Gangoli

Published in: Indian Journal of Surgical Oncology | Issue 1/2019

Abstract

PET/CT has made significant inroads into routine oncological practice in recent times. In our study, we aim to determine its value in preoperative assessment of endometrial carcinoma. A retrospective study between January 2011 and March 2016 was conducted; we included all cases of carcinoma endometrium with a preoperative PET/CT scan. PET/CT images were analyzed and correlated with histological findings after surgical staging. A total of 46 cases were analyzed, mean age was 59.8 years, BMI 30.8 kg/m², and most common histology endometrioid type (69.5%). We correlated PET/CT findings with histopathology as reference standard. PET/CT had a sensitivity of 40%, moderate specificity (75%) and accuracy (71.7%), good NPV (91.2%), but poor PPV (16.7%) for lymph node involvement. A total of 10 (21.7%) cases were detected to have distant metabolically active lesions on PET/CT, seven out of these were positive for malignancy. And 90% of them were either non-endometrioid type or grade two and higher. We found that SUV of primary tumor was significantly higher in patients with deep myometrial invasion (p = 0.018), and high-risk histological type of tumor (p = 0.022), though not statistically significant when lymph nodal involvement (p = 0.9), cervical involvement (p = 0.56), or histological grade (p = 0.84) were considered. Sensitivity and specificity of PET/CT in staging endometrial cancer is not high enough to reliably tailor lymphadenectomy. Although SUV of the primary tumor was significantly higher in patients with deep myometrial invasion and high-risk histological type, it’s usefulness in classifying patients into predefined risk groups seems to be limited. However, it is useful in detecting distant metastasis especially in high-grade and non-endometrioid type of tumors. Thus, implementation of PET/CT as a surrogate for surgical staging of endometrial cancer remains enigmatic and is open to further research.

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Title: Role of Positron Emission Tomography/Computed Tomography in Preoperative Assessment of Carcinoma Endometrium—a Retrospective Analysis
Authors: Rohini Kulkarni
Rani Akhil Bhat
Vibhawari Dhakharia
Kumar Kallur
Aparna Gangoli
Publication date: 01-03-2019
Publisher: Springer India
Published in: Indian Journal of Surgical Oncology / Issue 1/2019
Print ISSN: 0975-7651
Electronic ISSN: 0976-6952
DOI: https://doi.org/10.1007/s13193-018-0826-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Role of Positron Emission Tomography/Computed Tomography in Preoperative Assessment of Carcinoma Endometrium—a Retrospective Analysis

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

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