Chest computed tomography before evacuation of hydatidiform mole.

PURPOSE OF INVESTIGATION: To evaluate the usefulness of chest CT for assessing pulmonary micrometastasis in hydatidiform moles.

METHOD: We retrospectively evaluated 48 cases diagnosed with hydatidiform moles. We collected and compared data between the pulmonary micrometastatic and non-metastatic groups based on several factors. The non-parametric, Mann-Whitney, Kaplan-Meier and log-rank tests were used.

RESULTS: Of 14 patients who underwent chest CT at their initial evaluation, 57% had pulmonary micrometastasis. The time to remission of serum beta-hCG after evacuation, serum beta-hCG before evacuation and the largest diameter of the uterus were statistically significant. Persistent GTD developed in 38% of the metastatic group, but in only 25% of the nonmetastatic group. Micrometastasis was missed by chest X-ray in 64% of 11 patients suspected of having micrometastasis.

CONCLUSION: The chest X-ray was suspected of being ineffective in the diagnosis of pulmonary micrometastasis, but the use of chest CT should be considered during the initial evaluation of hydatidiform moles.