Comparison Of TVCDS And¹⁸F-FDG PET/CT Applicative Value In Gynecologic Malignant Tumor

Objective Ovarian cancer,endometrial cancer and cervical cancer are nearly more than90%of gynecologic malignant tumors,they are threat to women’s health,so accurate diagnosis and staging, after treatment monitoring have impartant influence on the survival and prognosis of patients. The results of TVCDS and18F-FDG PET/CT in67women with clinical suspicious gynecologic malignant tumors were retrospectively analyzed,to compare the preoperative evaluation and after treatment monitor value of TVCDS and F-FDG PET/CT in gynecologic malignant tumors.To provide more objective and accurate information for clinical diagnosis and treatment.Materials and methods The results of TVCDS and18F-FDG PET/CT in67women patients were retrospectively analyzed.All women were divided into two groups: Group145patients doubted the gynecologic malignant tumor before operation underwent TVCDS and18F-FDG PET/CT at diagnosis for staging. The patients’ average age was (56.6±13.9),ranging from25～88; Group222patients, who had chemoradiotherapy for6months to2years after operation, complete response more than6months, used TVCDS and18F-FDG PET/CT for monitor whether recurrence,metastasis or not. The patients’average age was (51.6±11.5), ranging from22～68. TVCDS can detect the morphology, size, border, echo intensity, structure feature and blood flow distribution of uterus, cervix, ovary and lesions. The18F-FDG PET/CT images were analyzed semi-quantitatively and visually by two doctors. Diagnosis of gynecologic malignant tumors were mainly based on lesions’maximal standardized uptake value (SUVmax), position, morphological characteristics, tracer concentration features and lesion distribution, and medical history of the patient,etc. Final diagnosis of the patients were confirmed with histopathology or clinical follow-up. Compared the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of two methods in diagnosis of primary tumors. Evaluate advantages and disadvantages of two methods in preoperative staging and after treatment monitoring. The findings of both modalities were analyzed statistically.Rusults(1)In Group1①45patients who with primary lesions, gynecological malignant tumors were32cases and benign lesions were13cases.32gynecological malignant tumors include ovarian cancer19(stageⅡ2、stageⅢ16、stageⅣ1), endometrial cancer7(stage Ⅰ3、stageⅢ1、stageⅣ3), cervical cancer6(stage Ⅰ1、 stageⅣ5).19malignant cases with pelvic metastases.13cases were benign lesions, included mucocele of the appendix1, ovrian cystadenoma1, ovrian tuberculosis3, uterine fibroid5, endometrial hyperplasia2, cervical polyp1.②30malignant tumors and10benign lesions were correctly diagnosed by TVCDS. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value of TVCDS on gynecological tumors were93.8%,76.9%,88.9%,90.9%,83.3%.16malignant cases with pelvic metastases were correctly diagnosed by TVCDS, the accuracy was84.4%.1case of endometrial cancer stage I a,2cases of endometrial cancer stage I b were correctly diagnosed by TVCDS.③31malignant tumors and11benign lesions were correctly diagnosed by PET/CT. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value of PET/CT on gynecological tumors were96.9%,84.6%,93.3%,93.9%,91.7%.18malignant cases with pelvic metastases were correctly diagnosed by PET/CT, the accuracy was96.9%. There was no information of muscular infiltration in PET/CT. More106metastases were found by PET/CT,1case was false negative.④the sensitivity, specificity, accuracy, positive predictive value, negative predictive value of PET/CT were higher than those of TVCDS and the accuracy of diagnosis pelvic metastases in PET/CT was higher than TVCDS, but there were no statistical significance (P>0.05).(2) In Group2①22patients who had treatment, there were17cases with recurrence.②7cases with recurrence were found by TVCDS, the accuracy was59.1%).③16cases recurrence were found by PET/CT, the accuracy was95.5%. PET/CT found31distant metastases in6cases whose TVCDS found many pelvic metastases and55distant metastases in5cases who only had higher tumor markers.④The accuracy of PET/CT was higher than it of TVCDS, and there was statistical significance (P<0.05).Conclusions1. The differences between PET/CT and TVCDS in sensitivity, specificity, accuracy, positive predictive value, negative predictive value and in accuracy of pelvic metastases were no statistical significance, but TVCDS can observe more clearly and directly, TVCDS have an advantage especially in staging of early endometrial cancer than PET/CT. PET/CT can evaluate primary lesions and metastases overally.2. The accuracy of pelvic metastases in patients who had treatment by PET/CT was higher than it by TVCDS. PET/CT could found more accurate lesions in patients whose TVCDS found many pelvic metastases or only had higher tumor markers.3. Both TVCDS and PET/CT have advantges.It is useful for treatment and monitoring by using these two methods reasonably.