Evaluation of lymph node metastasis in cervical cancer: A retrospective comparison of preoperative MRI and PET/CT with postoperative histopathology results

Abstract

Objective: The aim of this study is to assess the diagnostic performance of positron emission tomography/computed tomography (PET/CT) and magnetic resonance imaging (MRI) in detecting pelvic and paraaortic lymph node involvement in cervical cancer patients by correlating imaging results with surgical pathology findings. Materials and Methods: A retrospective analysis was conducted on cervical cancer patients treated at & Idot;stanbul Medeniyet University Prof. Dr. S & uuml;leyman Yal & ccedil;& imath;n City Hospital from 2016 to 2022. Patients who underwent preoperative PET/CT or MRI imaging and subsequent lymph node dissection were included. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated for each imaging modality. Results: Of the 75 cases reviewed, 52 met the inclusion criteria. PET/CT had higher specificity (94.1%) than MRI (82.4%), while MRI demonstrated greater sensitivity (55.6% vs. 50%). False-negative rates were 15.3% for MRI and 17.3% for PET/CT. Receiver operating characteristic analysis indicated an area under the curve of 0.78 for PET/CT and 0.69 for MRI. No statistically significant differences in sensitivity or specificity were observed, with both modalities showing complementary strengths. Conclusion: MRI and PET/CT each contribute significantly to preoperative cervical cancer evaluation, with MRI favored for local assessment and PET/CT for nodal detection. Combining both modalities enhances diagnostic accuracy. Further prospective research is required to confirm and strengthen these results. and improve imaging strategies for clinical practice.