High diagnostic value of 18F-FDG PET/CT in detecting endometrial cancer in patients with precancerous endometrial lesions

Objective: Up to 60% of patients with a precancerous endometrial lesion will ultimately be diagnosed with endometrial carcinoma. In the context of endometrial carcinoma, adequate surgical staging- including lymph-node assessment-should be performed and dictate the necessity of postoperative adjuvant treatments. Our main objective was to evaluate the diagnostic performance of preoperative identifying concomitant endometrial cancer in patients with confirmed precancerous endometrial lesions. Methods: All women diagnosed with a precancerous lesion between 2010 and 2018 in our center were included in this retrospective cohort study. Patients were then divided into groups according to whether or not a PET/CT was performed preoperatively and the presence of endometrial carcinoma at the final pathology. Results: A total of 128 patients met the inclusion criteria, of which 66 underwent PET/CT. The sensitivity of PET/CT in identifying carcinoma was 78.3%, with a specificity of 79.1%. PET/CT failed to identify carcinoma in 5 out of 66 patients (7.6%). In the PET/CT group, 18 of 23 patients (78.3%) had adequate surgical staging, compared to only 4 of 31 patients (12.9%) in the mapping.