A novel diagnostic criterion for lymph node metastasis in cervical cancer using multi-detector computed tomography.

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Abstract

[Objectives]The sensitivity of the current 10 mm cut-off diameter that is used to diagnose lymph node (LN) metastasis is too low. This is the first study to develop a new criterion to diagnose LN metastasis in a region-by-region manner using multi-detector computed tomography (MDCT). [Methods]1) The short-axis diameter of the LNs in MDCT images from 1-mm slices obtained immediately prior to surgery was compared with the pathological diagnosis in 78 uterine cervical cancer patients undergoing primary surgery. For the region-by-region analysis, we divided para-aortic and pelvic spaces into 13 regions. 2) In 28 cases in which patients received neoadjuvant chemotherapy (NAC) followed by surgery, we compared MDCT images before and after NAC. [Results]1) The optimal cut-off in the region-by-region analysis was 5 mm, yielding 71% sensitivity and 79% specificity. 2) NAC significantly decreased LN size (p < 0.0001). NAC decreased the number of swollen LN regions (> 5 mm) from 51% (81/158) to 26% (41/158). [Conclusions]The new criterion developed using MDCT could be effective for accurately assessing LN status. It also facilitates the assessment of NAC efficacy regarding the eradication of LN metastases.

Journal

  • Gynecologic oncology

    Gynecologic oncology 131(3), 701-707, 2013-12

    Elsevier Inc.

Codes

  • NII Article ID (NAID)
    120005357243
  • NII NACSIS-CAT ID (NCID)
    AA00660708
  • Text Lang
    ENG
  • Article Type
    journal article
  • ISSN
    0090-8258
  • Data Source
    IR 
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