In the management of cervical cancer, which imaging modality has the highest sensitivity for detecting pelvic lymph node metastasis?
- A Contrast-enhanced CT scan
- B MRI pelvis with diffusion-weighted imaging
- C PET/CT with 18F-FDG ✓
- D Transvaginal ultrasound
Correct answer: C. PET/CT with 18F-FDG
Explanation
PET/CT with 18F-FDG has the highest sensitivity (approximately 75-85%) and specificity (90-95%) for detecting pelvic and para-aortic lymph node metastasis in cervical cancer. It detects metabolic activity rather than relying on size criteria. CT and MRI have lower sensitivity as they depend on morphological criteria (short-axis diameter >10 mm), missing micrometastases in normal-sized nodes. Transvaginal ultrasound has limited utility for nodal assessment.
Reference: Derks M et al., Clinical Oncology (2017); NCCN Guidelines, 2024 ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.