A new clinical trial suggests ultrasound may be just as effective as more expensive imaging technologies for evaluating pelvic lymph nodes in cervical cancer patients.
Presented at the CANNES trial, researchers from three European gynecological oncology centers found that ultrasound met non-inferiority criteria compared to PET/CT and diffusion-weighted MRI for detecting pelvic lymph node metastases before surgery. This is critical because lymph node status determines treatment strategy.
Between 2021 and 2023, investigators enrolled 120 women with confirmed cervical cancer, stages IA1 to IIIC2. All received ultrasound and PET/CT; 108 also received MRI. Imaging results were compared against final surgical pathology.
For detecting macrometastases, ultrasound showed 79.3% sensitivity and 87.9% specificity versus 75.9% and 86.8% for PET/CT. MRI posted 70.8% sensitivity and 90.5% specificity. Diagnostic accuracy for ultrasound was 85.8%.
However, investigators caution that imaging cannot replace surgical staging for micrometastases, which often remain undetected. Sentinel lymph node biopsy with ultrastaging remains necessary in those cases.
Still, as the first prospective multicenter trial of its kind, CANNES provides strong evidence that ultrasound can offer a practical alternative where PET/CT or MRI access is limited. Standardized training will be key for broader adoption.