Detection of Lymph Node Metastasis in Ovarian Carcinoma and Uterine Corpus Carcinoma by Preoperative Computerized Tomography or Magnetic Resonance Imaging

Abstract

Preoperative CT or MRI findings were compared with the results of staging the laparotomy to evaluate the accuracy of CT or MRI for detecting pelvic and para-aortic lymph-node metastases. In evaluating CTs in 95 ovarian carcinomas, we examined plain and contrast images made in 1- to 1.5-cm-thick slices from the pubis to the xiphoid process. Lymph nodes 1.5 cm or larger were considered to be positive. MRIs of 60 uterine corpus carcinomas utilized T1-weighted contrast, T2-weighted, and short-inversion time inversion-recovery (STIR) images. CT had a sensitivity of 60.9% and a specificity of 93.1%. The positive and negative predictive values were 73.7% and 88.2%, respectively. The diagnostic accuracy of CT for detecting para-aortic lymph-node metastases exceeded that for pelvic node metastases. The results of MRI indicated that the T1-weighted image and STIR image were the most accurate in identifying metastatic nodes. These results indicate that the most practical approach might be to search for enlarged lymph nodes by CT, and to follow-up with MRI when CT scans are questionable.