ERKEN EVRE UTERİN SERVİKS KANSERLİ HASTALARDA PELVİK VE PARAAORTİK LENF NODU METASTAZLARININ SAPTANMASINDA 18F-FDG PET / BT'NİN TANISAL DEĞERİNİN BELİRLENMESİ To Determine the Diagnostic Value of 18F-FDG PET / CT in Detecting Pelvic and Paraaortic lymph Node Metastases in Patients with Early Stage Uterine Cervix Cancer.

OZET Amac: Bu calismanin amaci, erken evre uterin serviks kanserli hastalarda pelvik ve paraaortik lenf nodu metastazlarinin saptanmasinda 18F-florodeoksiglukoz Pozitron Emisyon tomografisi / Bilgisayarli Tomografi (PET/BT) 'nin tanisal degerini belirlemekti. Gerec ve Yontem: Radikal histerektomi ve sistemik pelvik ve paraaortik lenf nodu diseksiyonu oncesi PET/ BT goruntulemesi yapilan erken evre uterin serviks kanserli 18 hasta calismaya dahil edildi. Lenf nodlarinin histopatolojik degerlendirmesi tanisal standart olarak kabul edildi ve PET/BT bulgulari histopatolojik bulgularla karsilastirildi. Bulgular: 18 hastadan toplam 807 (577 pelvik - 230 paraaortik) lenf nodu orneklendi ve histopatolojik incelemede 5 (% 28) hastada 10 (%1,2) nod (8 pelvik - 2 paraaortik) pozitif bulundu. Genel nod bazli PET/ BT'nin duyarlilik, ozgulluk, pozitif prediktif deger (PPV), negatif prediktif deger (NPV) ve dogrulugu sirasiyla % 10 (1/10), % 100 (797/797), %100 (1/1) % 99 (797/806) ve % 99 (798/807) idi. Genel hasta bazli PET/BT'nin duyarlilik, ozgulluk, PPV, NPV ve dogrulugu sirasiyla %20 (1/5), %100 (13/13), % 100 (1/1), % 76 (13/17), %78 (14/18) idi. Sonuc: Erken evre uterin serviks kanserli hastalarin yonetiminde, mikrometastatik lenf nodu olan hastalarin PET / BT'de yanlis negatif olarak rapor edilebilecegi akilda tutulmalidir. Anahtar Kelimeler: Erken evre uterin serviks kanseri; Preoperatif FDG PET/BT; Pelvik ve paraaortik lenf nodu metastazi. ABSTRACT Objective: The aim of this study was to determine the diagnostic value of 18F-fluorodeoxyglucose Positron Emission Tomography / Computed Tomography (PET / CT) in detection of pelvic and paraaortic lymph node metastases in patients with early stage uterine cervix cancer. Materials and Methods: 18 patients with early stage uterine cervix cancer who underwent PET / CT imaging before radical hysterectomy and systemic pelvic and paraaortic lymph node dissection were included in the study. Histopathological evaluation of lymph nodes was accepted as the diagnostic standard and PET/CT findings were compared with histopathological findings. Results: Of the total 807 (577 pelvic ve 230 para- aortic) lymph nodes sampled from 18 patients, and 10 (1,2%) nodes (8 pelvik ve 2 paraaortic) in 5 (28%) patients were positive for metastasis at histopathologic examination. The overall node-based sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of PET/CT were 10% (1of 10), 100% (797 of 797), 100% (1 of 1), 99% (797 of 806), and 99% (798 of 807), respectively. Meanwhile, the overall patient-based sensitivity, specificity, PPV, NPV, and accuracy of PET/CT were 20% (1 of 5), 100% (13 of 13), 100% (1 of 1), 76% (13 of 17), and 78% (14 of 18), respectively. Conclusions: In the management of patients with early stage uterine cervix cancer, it should be kept in mind that patients with micro-metastatic lymph nodes can be reported as false negative in PET / CT. Key words: Early stage uterine cervix cancer; Preoperative PET / CT; Pelvic and paraaortic lymph node metastasis