Computed tomography in evaluation of extrapelvic lymphadenopathy in carcinoma of the cervix

The diagnostic value of computed tomography for detecting metastatic tumor in common iliac and/or paraaortic lymph nodes among 44 patients with cervical carcinoma was analyzed. Pathologic confirmation of nodal status was obtained in 33 patients with primary disease and 11 patients with recurrent disease, either by staging laparotomy (82%) or fine needle aspiration (18%). Nodal metastases were detected in 12 patients. Fine needle aspiration of nodes 1.5 cm or greater in size detected 67% of metastatic nodes. The sensitivity of computed tomography for detection of metastatic nodes was 75%, specificity 91%, negative predictive value 91%, and positive predictive value 75%. There appears to be a role for computed tomography and fine needle aspiration of enlarged nodes in patients with advanced or recurrent cervical carcinoma.