| Objective:To investigate the diagnostic value of 18F-FDG PET/CT in the cervical cancer staging and diagnosis of parametrial infiltration,compared with the diagnosis of MRI.Methods:Clinical and imaging data of 111 patients with pathologically diagnosed cervical cancer in our hospital were collected retrospectively.18F-FDG PET/CT and MRI images were evaluated by two radiologists.Calculate the accuracy of 18F-FDG PET/CT and MRI in the diagnosis of cervical cancer staging,the paired Chi-square test was used to evaluate the difference between the two.The accuracy,sensitivity,specificity and kappa value of 18F-FDG PET/CT and MRI in the diagnosis of parametrial infiltration were calculated;drawn the ROC curve,calculate the area under curve?AUC?.Wilcoxon signed rank test was used to analyze the difference between MRI and 18F-FDG PET/CT in parametrial infiltration visibility and diagnostic confidence.The values of SUVmax,SUVmean,TLG and MTV of cervical cancer lesions were recorded,drawn the ROC curve,calculate the AUC,the best imaging parameters for diagnosis of parametrial infiltration was screened.Results:The accuracy of 18F-FDG PET/CT in the diagnosis of cervical cancer staging was moderate,with 65.8%?73/111??kappa=0.519,95%CI,0.406-0.626?.The accuracy of MRI in the diagnosis of cervical cancer staging was good,with 71.2%?79/111??kappa=0.579,95%CI,0.461-0.693?,there was a statistical difference between the two?2=16.31,p<0.05?.The accuracy of 18F-FDG PET/CT and MRI in the diagnosis of parametrial infiltration was good,with 79.3%?88/111??kappa=0.570,95%CI,0.420-0.714?and 83.8%?93/111??kappa=0.679,95%CI,0.553-0.804?,respectively;the sensitivity and specificity of 18F-FDG PET/CT in the diagnosis of parametrial infiltration were 70.2%?33/47?and 86.0%?55/64?,and the sensitivity and specificity of MRI were 93.6%?44/47?and 76.6%?44/67?.The AUC of 18F-FDG PET/CT and MRI in diagnosis of parametrial infiltration were 0.781?95%CI,0.689-0.873?and0.851?95%CI,0.776-0.926?,respectively.There was no statistical difference between MRI and 18F-FDG PET/CT in the visibility of parametrial infiltration?Z=-1.089,P=0.276?,and no statistical difference in diagnostic confidence neither?Z=-1.377,P=0.168?;The AUC of SUVmax and SUVmean for parametrial infiltration is0.658?CI,0.557-0.760??0.649?CI,0.547-0.751?,their diagnostic efficacy was low,and the AUC of TLG and MTV's was 0.800?CI,0.719-0.880??0.763?CI,0.675-0.852?,their diagnostic efficacy of parametrial infiltration was moderate,the dignostic efficacy is highest when the cutoff values for TLG=47.5?g/ml×cm3?and MTV=8.5cm3.Conclusion:The diagnostic accuracy of 18F-FDG PET/CT in cervical cancer staging was moderate,slightly lower than that of MRI.Both of them have good accuracy in the diagnosis of parametrial infiltration,meanwhile,the metabolic parameters of 18F-FDG PET/CT TLG and MTV have certain diagnostic value for parametrial infiltration,and can assist the diagnosis of paralegal infiltration. |
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