dc.contributor.author | Rockall, AG | |
dc.contributor.author | Barwick, TD | |
dc.contributor.author | Wilson, W | |
dc.contributor.author | Singh, N | |
dc.contributor.author | Bharwani, N | |
dc.contributor.author | Sohaib, A | |
dc.contributor.author | Nobbenhuis, M | |
dc.contributor.author | Warbey, V | |
dc.contributor.author | Miquel, M | |
dc.contributor.author | Koh, D-M | |
dc.contributor.author | De Paepe, KN | |
dc.contributor.author | Martin-Hirsch, P | |
dc.contributor.author | Ghaem-Maghami, S | |
dc.contributor.author | Fotopoulou, C | |
dc.contributor.author | Stringfellow, H | |
dc.contributor.author | Sundar, S | |
dc.contributor.author | Manchanda, R | |
dc.contributor.author | Sahdev, A | |
dc.contributor.author | Hackshaw, A | |
dc.contributor.author | Cook, GJ | |
dc.contributor.author | MAPPING Study Group | |
dc.date.accessioned | 2021-12-07T15:01:03Z | |
dc.date.available | 2021-12-07T15:01:03Z | |
dc.date.issued | 2021-09-15 | |
dc.identifier.citation | Clinical cancer research : an official journal of the American Association for Cancer Research, 2021 | |
dc.identifier.issn | 1078-0432 | |
dc.identifier.uri | https://repository.icr.ac.uk/handle/internal/4917 | |
dc.identifier.eissn | 1557-3265 | |
dc.identifier.doi | 10.1158/1078-0432.ccr-21-1834 | |
dc.description.abstract | Purpose 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.format | Print-Electronic | |
dc.language | eng | |
dc.language.iso | eng | |
dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/4.0 | |
dc.subject | MAPPING Study Group | |
dc.title | Diagnostic 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.type | Journal Article | |
dcterms.dateAccepted | 2021-09-13 | |
rioxxterms.version | VoR | |
rioxxterms.versionofrecord | 10.1158/1078-0432.ccr-21-1834 | |
rioxxterms.licenseref.uri | https://creativecommons.org/licenses/by-nc-nd/4.0 | |
rioxxterms.licenseref.startdate | 2021-09-15 | |
rioxxterms.type | Journal Article/Review | |
dc.relation.isPartOf | Clinical cancer research : an official journal of the American Association for Cancer Research | |
pubs.notes | Not known | |
pubs.organisational-group | /ICR | |
pubs.organisational-group | /ICR/Primary Group | |
pubs.organisational-group | /ICR/Primary Group/Royal Marsden Clinical Units | |
pubs.publication-status | Published | |
pubs.embargo.terms | Not known | |
dc.contributor.icrauthor | Koh, Dow-Mu | en_US |