Abstract:
Objectives: Pelvic lymph nodes affection is a common finding in patients with gynecological cancers and it has an important effect on prognosis and survival of the patients. The ultimate goal was
to compare different radiological techniques used for detection of pelvic lymph nodes in patients with gynecological cancers, comparison between ultrasound, computerized tomography and magnetic resonance imaging in relation to operative and histopathological findings.
Patients and Methods: The study included 300 patients with gynecological cancers treated surgically. Assessment of pelvic lymph nodes metastasis using ultrasound, CT, MRI and clinical intra-operative examinations. Correlations between the results of pelvic lymph nodes affection techniques and the final histopathological examination were done.
Results: The study included 300 cases with operable gynecological cancers; 162 of them were with endometrial cancer, 129 of them were with ovarian cancer and 9 of them were with cervical cancer. Sensitivity of Ultrasound examination for malignant pelvic lymph nodes detection was 61.5 %, specificity of CT was 92.2%, accuracy of MRI was 63.3% and sensitivity, specificity and accuracy of clinical intra-operative assessment was 83%, 77% & 81 % respectively.
Conclusion: Clinical intra-operative pelvic lymph nodes assessment is the most sensitive tool to detect pathologically enlarged lymph nodes in comparison to ultrasound, CT and MRI, while MRI is the most specific tool.
