The Prospective Study Of The Value Of ¹⁸F-FDG PET/CT And MRI In The Clinical Application Of Cervical Cancer

Purpose:Investigating the diagnostic value of ¹⁸F-FDG PET/CT and MRI for cervical cancer,including primary tumor,vagina involvement and lymph node metastasis.Method:86 Cervical cancer patients were recruited prospectively between November 2019 and January 2021,with 43 underwent both PET/CT and MRI examination,26 underwent PET/CT examination,17 underwent MRI examination.All patients accept ¹⁸F-FDG PET/CT and/or MRI examination.Ultimately,all patients received a radical hysterectomy and systematic lymphadenectomy.We evaluated the diagnostic performance of ¹⁸F-FDG PET/CT and MRI using the final pathological diagnoses as the golden standard.Result:Both preoperative PET/CT and MRI diagnosis in cervical primary tumor has high sensitivity were 95.7%,98.3%.Measurement of tumor size using MRI has proven to be accurate.Although PET/CT has pitfalls in measuring tumor size,The SUVmax of primary tumor was significantly higher in patients with large tumors,poorly or undifferentiated histopathologic grades,lymph node metastasis and an advanced stage,be correlated with unfavorable clinical outcomes to some extent.PET/CT and MRI diagnosis and postoperative pathologic results in cervical vaginal involvement were 23.1%,80.0%,the differences between them have statistical significance（P=0.01）;specificity were 89.3%,84.0%,respectively（P>0.05）.For pelvic nodal metastasis,NPV of PET/CT、MRI and PET/CT combine MRI were82.0%、78.0%、78.8%respectively,without statistical differences.11 patients（18.0%）had nodal involvement at histological analysis and considered radiologic examination false negative findings.The FN rate was 18.0%for MRI examination and 22.2%for PET/CT and 21.3%for PET/CT combine MRI,the differences between them have no statistical significance（P=0.861）.Conclusion:Both PET/CT and MRI has satisfied sensitivity detecting primary tumor,while as for measuring tumor size,detecting vaginal involvement,MRI have an advantage over PET/CT.PET/CT,MRI and PET/CT combine MRI exhibited high NPV for lymph nodes detection（P>0.05）.But FN rate in lymph nodes detection is a clinical issue even for modern PET/CT or MRI.