Metastatic lymph nodes in patients with cervical cancer: detection with MR imaging and FDG PET

Radiology. 2001 Mar;218(3):776-82. doi: 10.1148/radiology.218.3.r01mr19776.


Purpose: To compare the diagnostic accuracy of magnetic resonance (MR) imaging with that of positron emission tomography (PET) with 2-[fluorine 18]fluoro-2-deoxy-D-glucose (FDG) for detecting metastatic lymph nodes in patients with cervical cancer.

Materials and methods: Before radical hysterectomy and pelvic lymphadenectomy in 35 patients with International Federation of Gynecology and Obstetrics stage IB or II cervical cancer, abdominal FDG-PET and MR imaging were performed. Malignancy criteria were a lymph node diameter of 1 cm or more at MR imaging and a focally increased FDG uptake at PET. The findings of FDG-PET and MR imaging were compared with histologic findings.

Results: Histologic examination revealed pN0-stage cancer in 24 patients and pN1-stage cancer in 11 patients. On a patient basis, node staging resulted in sensitivities of 0.91 with FDG-PET and 0.73 with MR imaging and specificities of 1.00 with FDG-PET and 0.83 with MR imaging. The positive predictive value (PPV) of FDG-PET was 1.00 and that of MR imaging, 0.67 (not significant). The metastatic involvement of lymph node sites was identified at FDG-PET with a PPV of 0.90; at MR imaging, 0.64 (P <.05, Fisher exact test).

Conclusion: Metabolic imaging with FDG-PET is an alternative to morphologic MR imaging for detecting metastatic lymph nodes in patients with cervical cancer.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Lymph Nodes / diagnostic imaging*
  • Lymph Nodes / pathology*
  • Lymphatic Metastasis / diagnostic imaging*
  • Lymphatic Metastasis / pathology*
  • Magnetic Resonance Imaging*
  • Middle Aged
  • Predictive Value of Tests
  • Radiopharmaceuticals*
  • Sensitivity and Specificity
  • Tomography, Emission-Computed*
  • Uterine Cervical Neoplasms / pathology*


  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18