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dc.contributor.authorRockall, AG
dc.contributor.authorBarwick, TD
dc.contributor.authorWilson, W
dc.contributor.authorSingh, N
dc.contributor.authorBharwani, N
dc.contributor.authorSohaib, A
dc.contributor.authorNobbenhuis, M
dc.contributor.authorWarbey, V
dc.contributor.authorMiquel, M
dc.contributor.authorKoh, D-M
dc.contributor.authorDe Paepe, KN
dc.contributor.authorMartin-Hirsch, P
dc.contributor.authorGhaem-Maghami, S
dc.contributor.authorFotopoulou, C
dc.contributor.authorStringfellow, H
dc.contributor.authorSundar, S
dc.contributor.authorManchanda, R
dc.contributor.authorSahdev, A
dc.contributor.authorHackshaw, A
dc.contributor.authorCook, GJ
dc.contributor.authorMAPPING Study Group
dc.identifier.citationClinical cancer research : an official journal of the American Association for Cancer Research, 2021
dc.description.abstractPurpose Preoperative nodal staging is important for planning treatment in cervical cancer and endometrial cancer, but remains challenging. We compare nodal staging accuracy of 18 F-ethyl-choline-(FEC)-PET/CT, 18 F-fluoro-deoxy-glucose-(FDG)-PET/CT, and diffusion-weighted-MRI (DW-MRI) with conventional morphologic MRI. Experimental design A prospective, multicenter observational study of diagnostic accuracy for nodal metastases was undertaken in 5 gyne-oncology centers. FEC-PET/CT, FDG-PET/CT, and DW-MRI were compared with nodal size and morphology on MRI. Reference standard was strictly correlated nodal histology. Eligibility included operable cervical cancer stage ≥ 1B1 or endometrial cancer (grade 3 any stage with myometrial invasion or grade 1-2 stage ≥ II). Results Among 162 consenting participants, 136 underwent study DW-MRI and FDG-PET/CT and 60 underwent FEC-PET/CT. In 118 patients, 267 nodal regions were strictly correlated at histology (nodal positivity rate, 25%). Sensitivity per patient ( n = 118) for nodal size, morphology, DW-MRI, FDG- and FEC-PET/CT was 40%*, 53%, 53%, 63%*, and 67% for all cases (*, P = 0.016); 10%, 10%, 20%, 30%, and 25% in cervical cancer ( n = 40); 65%, 75%, 70%, 80% and 88% in endometrial cancer ( n = 78). FDG-PET/CT outperformed nodal size ( P = 0.006) and size ratio ( P = 0.04) for per-region sensitivity. False positive rates were all <10%. Conclusions All imaging techniques had low sensitivity for detection of nodal metastases and cannot replace surgical nodal staging. The performance of FEC-PET/CT was not statistically different from other techniques that are more widely available. FDG-PET/CT had higher sensitivity than size in detecting nodal metastases. False positive rates were low across all methods. The low false positive rate demonstrated by FDG-PET/CT may be helpful in arbitration of challenging surgical planning decisions.
dc.subjectMAPPING Study Group
dc.titleDiagnostic Accuracy of FEC-PET/CT, FDG-PET/CT, and Diffusion-Weighted MRI in Detection of Nodal Metastases in Surgically Treated Endometrial and Cervical Carcinoma.
dc.typeJournal Article
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfClinical cancer research : an official journal of the American Association for Cancer Research
pubs.notesNot known
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.embargo.termsNot known
dc.contributor.icrauthorKoh, Dow-Muen_US

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