Application of apparent diffusion coefficient values derived from diffusion-weighted imaging for assessing different sized metastatic lymph nodes in cervical cancers

Zhang, Aining; Song, Jiacheng; Ma, Zhanlong; Chen, Ting

doi:10.1177/0284185119879686

Cited by 16 publications

(9 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…When the ADC min value of 0.72 × 10 −3 mm 2 /s was used as a cut-off value, the best validity results were obtained, with the sensitivity of 83.1%, specificity of 89.6%, and accuracy of 83.7%. These results were consistent with the previous study by Zhang et al 14 Nevertheless, using DWI alone is not accurate enough to rule in or out PLN metastases.…”

Section: Discussionsupporting

confidence: 92%

Diagnostic Value of Multimodal Magnetic Resonance Imaging in Discriminating Between Metastatic and Non-Metastatic Pelvic Lymph Nodes in Cervical Cancer

Xu¹,

Ma²,

Mei³

et al. 2022

IJGM

View full text Add to dashboard Cite

Background The status of pelvic lymph node (PLN) metastasis affects treatment and prognosis plans in patients with cervical cancer. However, it is hard to be diagnosed in clinical practice. Purpose The present study aimed to evaluate the diagnostic value of multimodal magnetic resonance imaging (MRI) in discriminating between metastatic and non-metastatic pelvic lymph nodes (PLNs) in cervical cancer. Methods This retrospective study analyzed MRIs of 209 PLNs in 25 women with pathologically proven cervical cancer. All PLNs had been assessed by pre-treatment multimodal MRIs, and their status was finally confirmed by histopathology. In conventional MRI, lymph node characteristics were compared between metastatic and non-metastatic PLNs. Signal intensity, time–intensity curve (TIC) patterns minimal and mean apparent diffusion coefficients (ADC) were compared between them in DWI. In DCE-MRI, quantitative (K trans , K ep and V e ) analyses were performed on DCE-MRI sequences, and their predictive values were analyzed by ROC curves. Results Of 209 PLNs, 22 (10.53%) were metastases and 187 (89.47%) were non-metastases at histopathologic examination. Considering a comparison of lymph node characteristics, the short axis size, the long axis size, and the boundary differed significantly between the two groups ( P <0.05).The differences in ADC min , TIC types, K trans and V e between metastatic and non-metastatic PLNs were significant as well ( P <0.05). The good diagnostic performance of multimodal MRI was shown in discriminating between metastatic and non-metastatic PLNs, with the sensitivity of 85.0% (17/20), specificity of 97.3% (184/189), and accuracy of 96.2% (201/209). ROC analyses showed that the diagnostic accuracy of ADC min , K trans and V e for discriminating between metastatic and non-metastatic PLNs in cervical cancer was 83.7%, 91.4%, and 92.4% with the cut-off values of 0.72 × 10 −3 mm 2 /s, 0.52 min −1 , and 0.53 min −1 , respectively. Conclusion Multimodal MRI showed good diagnostic performance in determining PLN status in cervical cancer.

show abstract

Section: Discussionsupporting

confidence: 92%

Diagnostic Value of Multimodal Magnetic Resonance Imaging in Discriminating Between Metastatic and Non-Metastatic Pelvic Lymph Nodes in Cervical Cancer

Xu¹,

Ma²,

Mei³

et al. 2022

IJGM

View full text Add to dashboard Cite

show abstract

“…Overall, the whole-lesion ADC histogram parameters of RS-EPI DWI based on primary cervical cancer analysis performed well in identifying normal-sized LNM, and the results were similar to previous studies 6,34 based on lymph node analysis. However, our method of analyzing the primary tumor is more adaptable to clinical practice because it is difficult to preoperatively evaluate each lymph node because of the scanning thickness and the location and size of lymph nodes.…”

Section: Discussionsupporting

confidence: 84%

“…A possible explanation for this finding could be that more aggressive tumors may contain many invisible cystic and necrotic components. 30 However, Zhang et al 6 reported that ADC min had the highest value in distinguishing normal-sized LNM in cervical cancer. Although ADC min theoretically best represents the most aggressive component of a tumor, it is more susceptible to noise, artifacts, and adjacent structures.…”

Section: Discussionmentioning

confidence: 99%

“…At present, magnetic resonance imaging (MRI) is still the mainstream method for preoperative LNM risk assessment 5 . Unfortunately, the generally accepted size criteria (≥10 mm in the short axis) for identifying LNM may lead to unsatisfactory sensitivity and accuracy because of pitfalls in evaluating normal-sized metastatic lymph nodes 6,7 . This is especially true when the radiological evidence for LNM assessment is first incorporated into the new version of the International Federation of Gynecology and Obstetrics (FIGO) staging, 8 which poses a new challenge in identifying normal-sized LNM.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Whole-Lesion Apparent Diffusion Coefficient Histogram Analysis for Assessing Normal-Sized Lymph Node Metastasis in Cervical Cancer: Comparison Between Readout-Segmented and Single-Shot Echo-Planar Diffusion-Weighted Imaging

Qian¹,

Chen

2023

J Comput Assist Tomogr

View full text Add to dashboard Cite

Objective: To compare the value of whole-lesion apparent diffusion coefficient (ADC) histogram analysis derived from readout-segmented echo-planar imaging (RS-EPI) and single-shot echo-planar imaging (SS-EPI) diffusion-weighted imaging (DWI) in evaluating normal-sized lymph node metastasis (LNM) in cervical cancer.Methods: Seventy-six pathologically confirmed cervical cancer patients (stages IB and IIA) were enrolled, including 61 patients with non-LNM (group A) and 15 patients with normal-sized LNM (group B). The recorded tumor volume on T2-weighted imaging was the reference against which both DWIs were evaluated. Each ADC histogram parameter (including ADC max , ADC 90 , ADC median , ADC mean , ADC 10 , ADC min , ADC skewness , ADC kurtosis , and ADC entropy ) was compared between SS-EPI and RS-EPI and between the 2 groups.Results: There was no significant difference in tumor volume between the 2 DWIs and T2-weighted imaging (both P > 0.05). Higher ADC max and ADC entropy but lower ADC 10 , ADC min and ADC skewness were found in SS-EPI than those in RS-EPI (all P < 0.05). For SS-EPI, lower ADC 90 and higher ADC kurtosis were found in group B than those in group A (both P < 0.05). For RS-EPI, lower ADC 90 and higher ADC kurtosis and ADC entropy were found in group B than those in group A (all P < 0.05). Readout-segmented echo-planar imaging ADC kurtosis showed the highest area under the curve of 0.792 in the differentiation of the 2 groups (sensitivity, 80%; specificity, 73.77%).Conclusions: Compared with SS-EPI, the ADC histogram parameters derived from RS-EPI were more accurate, and ADC kurtosis held great potential in differentiating normal-sized LNM in cervical cancer.

show abstract

“…Full-thickness cervical stromal invasion does not always signify parametrial invasion. The diagnosis of parametrial invasion requires full-thickness cervical stromal invasion and one of the following additional findings on T2WI: a speculated tumor-to-parametrial interface, a tumor nodule in the parametrium and/or tumor encasement of parametrial vessels [ 50 ].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Accuracy of Magnetic Resonance Imaging in the Pre-Operative Staging of Cervical Cancer Patients Who Underwent Neoadjuvant Treatment: A Clinical–Surgical–Pathologic Comparison

Ditto

Maggiore

Evangelisti

et al. 2023

Cancers

View full text Add to dashboard Cite

Magnetic resonance imaging (MRI) has been proven to ensure high diagnostic accuracy in the identification of vaginal, parametrial, and lymph node involvement in patients affected by cervical cancer (CC), thus playing a crucial role in the preoperative staging of the disease. This study aims to compare the accuracy of MRI for the preoperative staging of patients with CC who underwent neoadjuvant treatment (NAT) or direct surgery. Retrospective data analysis of 126 patients with primary CC International Federation of Gynecology and Obstetrics stage IB3-IIB who underwent NAT before radical surgery (NAT group = 94) or received surgical treatment alone (control arm = 32) was prospectively performed. All enrolled patients were clinically assessed with both a pelvic examination and MRI before surgical treatment. Data from the clinical examination were compared with the histopathological findings to assess the accuracy of MRI for staging purposes after NAT or before direct surgery. MRI showed an overall accuracy of 46.1%, proving it to be not superior to pelvic and physical examination. The overall MRI accuracy for the evaluation of parametrial, vaginal, and lymph node status was 65.8%, 79.4%, and 79.4%, respectively. In the NAT group, the accuracy for the detection of parametrial, lymph node, and vaginal involvement was lower than the control group; however, the difference was not significant (p ≥ 0.05). The overall accuracy of MRI for the preoperative staging of CC after NAT is shown to be not unsatisfactory. The limits of MRI staging are especially evident when dealing with pre-treated patients.

show abstract

Application of apparent diffusion coefficient values derived from diffusion-weighted imaging for assessing different sized metastatic lymph nodes in cervical cancers

Cited by 16 publications

References 28 publications

Diagnostic Value of Multimodal Magnetic Resonance Imaging in Discriminating Between Metastatic and Non-Metastatic Pelvic Lymph Nodes in Cervical Cancer

Diagnostic Value of Multimodal Magnetic Resonance Imaging in Discriminating Between Metastatic and Non-Metastatic Pelvic Lymph Nodes in Cervical Cancer

Whole-Lesion Apparent Diffusion Coefficient Histogram Analysis for Assessing Normal-Sized Lymph Node Metastasis in Cervical Cancer: Comparison Between Readout-Segmented and Single-Shot Echo-Planar Diffusion-Weighted Imaging

Diagnostic Accuracy of Magnetic Resonance Imaging in the Pre-Operative Staging of Cervical Cancer Patients Who Underwent Neoadjuvant Treatment: A Clinical–Surgical–Pathologic Comparison

Contact Info

Product

Resources

About