Comparison of positron emission tomography with computed tomography examination with histopathological assessment of pelvic lymph nodes in patients with cervical cancer treated surgically

Introduction
According to the literature, fluor-18-fluorodeoxyglucose positron emission tomography with computed tomography (¹⁸F-FDG-PET-CT) is the most effective technique for the examination and detection of metastases in the lymph nodes in patients with cervical cancer. This study aimed to compare the diagnostic value of the preoperative evaluation using ¹⁸F-FDG-PET-CT with a histopathological examination of the lymph nodes removed during radical hysterectomy and pelvic lymph node dissection in patients with cervical cancer.

Material and methods
Retrospective analysis covered the medical records of 42 patients with cervical cancer (stage IA–IB according to International Federation of Gynaecology and Obstetrics 2009) treated with radical Piver type III hysterectomy and pelvic lymph node dissection. The preoperative diagnosis was made using a PET/CT examination.

Results
The result of the ¹⁸F-FDG-PET-CT examination highlighted a suspicion of lymph node metastases in 13 patients (31%). The histopathological examination confirmed this in 12 patients (29%). Metastatic lymph nodes were correctly diagnosed using ¹⁸F-FDG-PET-CT in 8 out of the 12 cases confirmed by the histopathological examination. In the patient-based study, sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 66.8%, 83.3%, 61.5%, 86.2 % and 78.6%, respectively.

Conclusions
We confirmed the usefulness of PET in the preoperative assessment of cervical cancer advancement, especially in correlation with the new 2018 International Federation of Gynaecology and Obstetrics staging system.