MRI, PET/CT and ultrasound in the preoperative staging of endometrial cancer - A multicenter prospective comparative study

Sofie Leisby Antonsen; Lisa Neerup Jensen; Annika Loft; Anne Kiil Berthelsen; Junia Costa; Ann Tabor; Ingelise Qvist; Mette Rodi Hansen; Rune Vincents Fisker; Erik Søgaard Andersen; Lene Sperling; Anne Lerberg Nielsen; Jon Asmussen; Estrid Høgdall; Carsten L Fagö-Olsen; Ib Jarle Christensen; Lotte Nedergaard; Kirsten Væver Jochumsen; Claus Høgdall

doi:10.1016/j.ygyno.2012.11.025

MRI, PET/CT and ultrasound in the preoperative staging of endometrial cancer - A multicenter prospective comparative study

Sofie Leisby Antonsen, Lisa Neerup Jensen, Annika Loft, Anne Kiil Berthelsen, Junia Costa, Ann Tabor, Ingelise Qvist, Mette Rodi Hansen, Rune Vincents Fisker, Erik Søgaard Andersen, Lene Sperling, Anne Lerberg Nielsen, Jon Asmussen, Estrid Høgdall, Carsten L Fagö-Olsen, Ib Jarle Christensen, Lotte Nedergaard, Kirsten Væver Jochumsen, Claus Høgdall

150 Citations (Scopus)

Abstract

OBJECTIVES: The aim of this prospective multicenter study was to evaluate and compare the diagnostic performance of PET/CT, MRI and transvaginal two-dimensional ultrasound (2DUS) in the preoperative assessment of endometrial cancer (EC). METHODS: 318 consecutive women with EC were included when referred to three Danish tertiary gynecological centers for surgical treatment. Preoperatively they were PET/CT-, MRI-, and 2DUS scanned. The imaging results were compared to the final pathological findings. This study was approved by the National Committee on Health Research Ethics. RESULTS: For predicting myometrial invasion, we found sensitivity, specificity, PPV, NPV, and accuracy for PET/CT to be 93%, 49%, 41%, 95% and 61%, for MRI to be 87%, 57%, 44%, 92%, and 66% and for 2DUS to be 71%, 72%, 51%, 86% and 72%. For predicting cervical invasion, the values were 43%, 94%, 69%, 85% and 83%, respectively, for PET/CT, 33%, 95%, 60%, 85%, and 82%, respectively, for MRI, and 29%, 92%, 48%, 82% and 78% for 2DUS. Finally, for lymph node metastases, the values were 74%, 93%, 59%, 96%, and 91% for PET/CT and 59%, 93%, 40%, 97% and 90% for MRI. When comparing the diagnostic performance we found PET/CT, MRI and 2DUS to be comparable in predicting myometrial invasion. For cervical invasion and lymph node metastases, however, PET/CT was the best. CONCLUSIONS: None of the modalities can yet replace surgical staging. However, they all contributed to important knowledge and were, furthermore, able to upstage low-risk patients who would not have been recommended lymph node resection based on histology and grade alone.

Original language	English
Journal	Journal of Gynecologic Oncology Nursing
Volume	128
Issue number	2
Pages (from-to)	300- 8
ISSN	1536-9935
DOIs	https://doi.org/10.1016/j.ygyno.2012.11.025
Publication status	Published - Feb 2013

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10.1016/j.ygyno.2012.11.025

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Antonsen, S. L., Jensen, L. N., Loft, A., Berthelsen, A. K., Costa, J., Tabor, A., Qvist, I., Hansen, M. R., Fisker, R. V., Andersen, E. S., Sperling, L., Nielsen, A. L., Asmussen, J., Høgdall, E., Fagö-Olsen, C. L., Christensen, I. J., Nedergaard, L., Jochumsen, K. V., & Høgdall, C. (2013). MRI, PET/CT and ultrasound in the preoperative staging of endometrial cancer - A multicenter prospective comparative study. Journal of Gynecologic Oncology Nursing, 128(2), 300- 8. https://doi.org/10.1016/j.ygyno.2012.11.025

Antonsen, SL, Jensen, LN, Loft, A, Berthelsen, AK, Costa, J, Tabor, A, Qvist, I, Hansen, MR, Fisker, RV, Andersen, ES, Sperling, L, Nielsen, AL, Asmussen, J, Høgdall, E, Fagö-Olsen, CL, Christensen, IJ, Nedergaard, L, Jochumsen, KV & Høgdall, C 2013, 'MRI, PET/CT and ultrasound in the preoperative staging of endometrial cancer - A multicenter prospective comparative study', Journal of Gynecologic Oncology Nursing, vol. 128, no. 2, pp. 300- 8. https://doi.org/10.1016/j.ygyno.2012.11.025

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title = "MRI, PET/CT and ultrasound in the preoperative staging of endometrial cancer - A multicenter prospective comparative study",

abstract = "OBJECTIVES: The aim of this prospective multicenter study was to evaluate and compare the diagnostic performance of PET/CT, MRI and transvaginal two-dimensional ultrasound (2DUS) in the preoperative assessment of endometrial cancer (EC). METHODS: 318 consecutive women with EC were included when referred to three Danish tertiary gynecological centers for surgical treatment. Preoperatively they were PET/CT-, MRI-, and 2DUS scanned. The imaging results were compared to the final pathological findings. This study was approved by the National Committee on Health Research Ethics. RESULTS: For predicting myometrial invasion, we found sensitivity, specificity, PPV, NPV, and accuracy for PET/CT to be 93%, 49%, 41%, 95% and 61%, for MRI to be 87%, 57%, 44%, 92%, and 66% and for 2DUS to be 71%, 72%, 51%, 86% and 72%. For predicting cervical invasion, the values were 43%, 94%, 69%, 85% and 83%, respectively, for PET/CT, 33%, 95%, 60%, 85%, and 82%, respectively, for MRI, and 29%, 92%, 48%, 82% and 78% for 2DUS. Finally, for lymph node metastases, the values were 74%, 93%, 59%, 96%, and 91% for PET/CT and 59%, 93%, 40%, 97% and 90% for MRI. When comparing the diagnostic performance we found PET/CT, MRI and 2DUS to be comparable in predicting myometrial invasion. For cervical invasion and lymph node metastases, however, PET/CT was the best. CONCLUSIONS: None of the modalities can yet replace surgical staging. However, they all contributed to important knowledge and were, furthermore, able to upstage low-risk patients who would not have been recommended lymph node resection based on histology and grade alone.",

author = "Antonsen, {Sofie Leisby} and Jensen, {Lisa Neerup} and Annika Loft and Berthelsen, {Anne Kiil} and Junia Costa and Ann Tabor and Ingelise Qvist and Hansen, {Mette Rodi} and Fisker, {Rune Vincents} and Andersen, {Erik S{\o}gaard} and Lene Sperling and Nielsen, {Anne Lerberg} and Jon Asmussen and Estrid H{\o}gdall and Fag{\"o}-Olsen, {Carsten L} and Christensen, {Ib Jarle} and Lotte Nedergaard and Jochumsen, {Kirsten V{\ae}ver} and Claus H{\o}gdall",

year = "2013",

month = feb,

doi = "10.1016/j.ygyno.2012.11.025",

language = "English",

volume = "128",

pages = "300-- 8",

journal = "Journal of Gynecologic Oncology Nursing",

issn = "1536-9935",

publisher = "Society of Gynecologic Nurse Oncologists",

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TY - JOUR

T1 - MRI, PET/CT and ultrasound in the preoperative staging of endometrial cancer - A multicenter prospective comparative study

AU - Antonsen, Sofie Leisby

AU - Jensen, Lisa Neerup

AU - Loft, Annika

AU - Berthelsen, Anne Kiil

AU - Costa, Junia

AU - Tabor, Ann

AU - Qvist, Ingelise

AU - Hansen, Mette Rodi

AU - Fisker, Rune Vincents

AU - Andersen, Erik Søgaard

AU - Sperling, Lene

AU - Nielsen, Anne Lerberg

AU - Asmussen, Jon

AU - Høgdall, Estrid

AU - Fagö-Olsen, Carsten L

AU - Christensen, Ib Jarle

AU - Nedergaard, Lotte

AU - Jochumsen, Kirsten Væver

AU - Høgdall, Claus

PY - 2013/2

Y1 - 2013/2

N2 - OBJECTIVES: The aim of this prospective multicenter study was to evaluate and compare the diagnostic performance of PET/CT, MRI and transvaginal two-dimensional ultrasound (2DUS) in the preoperative assessment of endometrial cancer (EC). METHODS: 318 consecutive women with EC were included when referred to three Danish tertiary gynecological centers for surgical treatment. Preoperatively they were PET/CT-, MRI-, and 2DUS scanned. The imaging results were compared to the final pathological findings. This study was approved by the National Committee on Health Research Ethics. RESULTS: For predicting myometrial invasion, we found sensitivity, specificity, PPV, NPV, and accuracy for PET/CT to be 93%, 49%, 41%, 95% and 61%, for MRI to be 87%, 57%, 44%, 92%, and 66% and for 2DUS to be 71%, 72%, 51%, 86% and 72%. For predicting cervical invasion, the values were 43%, 94%, 69%, 85% and 83%, respectively, for PET/CT, 33%, 95%, 60%, 85%, and 82%, respectively, for MRI, and 29%, 92%, 48%, 82% and 78% for 2DUS. Finally, for lymph node metastases, the values were 74%, 93%, 59%, 96%, and 91% for PET/CT and 59%, 93%, 40%, 97% and 90% for MRI. When comparing the diagnostic performance we found PET/CT, MRI and 2DUS to be comparable in predicting myometrial invasion. For cervical invasion and lymph node metastases, however, PET/CT was the best. CONCLUSIONS: None of the modalities can yet replace surgical staging. However, they all contributed to important knowledge and were, furthermore, able to upstage low-risk patients who would not have been recommended lymph node resection based on histology and grade alone.

AB - OBJECTIVES: The aim of this prospective multicenter study was to evaluate and compare the diagnostic performance of PET/CT, MRI and transvaginal two-dimensional ultrasound (2DUS) in the preoperative assessment of endometrial cancer (EC). METHODS: 318 consecutive women with EC were included when referred to three Danish tertiary gynecological centers for surgical treatment. Preoperatively they were PET/CT-, MRI-, and 2DUS scanned. The imaging results were compared to the final pathological findings. This study was approved by the National Committee on Health Research Ethics. RESULTS: For predicting myometrial invasion, we found sensitivity, specificity, PPV, NPV, and accuracy for PET/CT to be 93%, 49%, 41%, 95% and 61%, for MRI to be 87%, 57%, 44%, 92%, and 66% and for 2DUS to be 71%, 72%, 51%, 86% and 72%. For predicting cervical invasion, the values were 43%, 94%, 69%, 85% and 83%, respectively, for PET/CT, 33%, 95%, 60%, 85%, and 82%, respectively, for MRI, and 29%, 92%, 48%, 82% and 78% for 2DUS. Finally, for lymph node metastases, the values were 74%, 93%, 59%, 96%, and 91% for PET/CT and 59%, 93%, 40%, 97% and 90% for MRI. When comparing the diagnostic performance we found PET/CT, MRI and 2DUS to be comparable in predicting myometrial invasion. For cervical invasion and lymph node metastases, however, PET/CT was the best. CONCLUSIONS: None of the modalities can yet replace surgical staging. However, they all contributed to important knowledge and were, furthermore, able to upstage low-risk patients who would not have been recommended lymph node resection based on histology and grade alone.

U2 - 10.1016/j.ygyno.2012.11.025

DO - 10.1016/j.ygyno.2012.11.025

M3 - Journal article

C2 - 23200916

SN - 1536-9935

VL - 128

SP - 300

EP - 308

JO - Journal of Gynecologic Oncology Nursing

JF - Journal of Gynecologic Oncology Nursing

IS - 2

ER -

MRI, PET/CT and ultrasound in the preoperative staging of endometrial cancer - A multicenter prospective comparative study

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