Detection and Characterization of Metastatic Cervical Adenopathy by MR Imaging

Mw, van den Brekel; Ja, Castelijns; Hv, Stel; Valk, Jacob; Ga, Croll; Rp, Golding; Wj, Luth; Cj, Meyer; Gb, Snow

doi:10.1097/00004728-199007000-00014

Cited by 72 publications

(8 citation statements)

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“…MRI of the neck has shown that heterogeneous signal intensity on contrast-enhanced T1-weighted images is a good indicator of metastatic nodes [23,24]. Heterogeneous enhancement of lymph nodes could be the result of tumor infiltration of the lymph nodes, necrosis, or a mucin pool, but in the present study, application of the enhancement pattern criterion did not distinguish metastatic from nonmetastatic nodes.…”

Section: Discussioncontrasting

confidence: 71%

MRI for Pretreatment Lymph Node Staging in Uterine Cervical Cancer

Choi

Kim

Seo

et al. 2006

American Journal of Roentgenology

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WEBThis is a Web exclusive article.OBJECTIVE. The purpose of this article is to assess the accuracy of MRI in detecting pelvic and paraaortic lymph node metastasis from uterine cervical cancer using various imaging criteria.CONCLUSION. Although MRI analysis resulted in relatively low sensitivity, size and margin (spiculated or lobulated) were useful criteria for predicting lymph node metastasis from cervical cancer.ervical cancer is the second most frequently diagnosed malignancy in women worldwide, and it is the only major gynecologic malignancy clinically staged according to International Federation of Obstetrics and Gynecology (FIGO) recommendations [1]. Clinical staging of cervical cancers is accurate in only approximately 60% of cases, which is far less than surgical staging accuracy [2,3]. Lymph node metastasis is not a factor for FIGO staging; however, nodal metastases in gynecologic malignancies have an adverse impact on survival, especially in cases of paraaortic node involvement in cervical cancer [4,5]. Although nodal resection before radiation therapy results in a higher survival rate in patients with grossly enlarged pelvic and paraaortic lymph nodes [6,7], routine pretreatment surgical staging is not recommended. For this reason, inaccurate pretreatment assessment of lymph node involvement can lead to suboptimal treatment [8,9].CT and MRI have been used to assess paraaortic and pelvic lymph nodes in patients with cervical cancer. A meta-analysis of such studies concluded that these methods have only moderate sensitivity and specificity for detecting metastases [10]. These studies relied on the size and shape of lymph nodes, and the analyses were based on region-specific comparisons. It was reported that margin and appearance are valid criteria for assessing lymph node metastasis from rectal cancer [11]. However, to our knowledge, no reports define the validity of criteria other than size and shape, and no reports have described node-by-node comparisons in the detection of metastatic pelvic lymph nodes in patients with uterine cervical carcinoma.The purpose of this study was to assess the accuracy of MRI in detecting metastatic lymph nodes in cervical cancer patients using various imaging criteria. Materials and Methods Patients and Staging WorkupPatients included in this retrospective study were those with histopathologically confirmed FIGO stages IB-IVA invasive cervical cancer, which was determined by a conventional workup that included MRI. Patients were recruited between October 2001 and October 2004, ranged in age from 18 to 65 years (mean age, 48 years), had no contraindications to the surgical procedure, had no evidence of distant metastases, and had an Eastern Cooperative Oncology Group performance status of 0-1. Patients with small cell carcinoma (n = 2) and patients who were not to undergo laparoscopic lymph node dissection (n = 63) were excluded.After histologic confirmation of invasive cervical carcinoma, the FIGO stage was determined using bimanual pelvic examination, excretory urograp...

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Section: Discussioncontrasting

confidence: 71%

MRI for Pretreatment Lymph Node Staging in Uterine Cervical Cancer

Choi

Kim

Seo

et al. 2006

American Journal of Roentgenology

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“…Magnetic resonance imaging scans were reassessed, blinded to pathological neck staging and outcomes, by a single radiologist (RH). Standard radiological criteria for nodal status were used, with ECS suspected when there was high signal change or oedema surrounding the nodes or the fat suppressed on STIR (short T1 inversion recovery) images, when the margins of the nodal masses were indistinct, or when the nodal masses invaded the overlying sternocleidomastoid muscle (van den Brekel et al, 1990;Lwin et al, 2012).…”

Section: Methodsmentioning

confidence: 99%

SERPINE1 and SMA expression at the invasive front predict extracapsular spread and survival in oral squamous cell carcinoma

Dhanda

Triantafyllou

Lilogou

et al. 2015

British Journal of Oral and Maxillofacial Surgery

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“…In the current study 2 patients who were correctly staged locally as having T3b tumours were understaged with regard to lymph node status, the regional nodes being involved with micrometastases. Workers studying the regional lymphatics of other organs in the body have suggested that gadolinium enhancement may improve the detection rate for small involved nodes and this may well be a tool for the future (Van den Brekel et al, 1990). appear as a very low or absent signal because of the signal void from flowing blood.…”

Section: Discussionmentioning

confidence: 99%

Magnetic Resonance Imaging in the Staging of Bladder Cancer

Persad

Kabala

Gillatt

et al. 1993

British Journal of Urology

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Magnetic resonance imaging (MRI) scans were performed on 55 bladder cancer patients on whom clinicopathological staging was available from transurethral resection and cystectomy specimens. The overall accuracy of MRI scanning in this group was 84%, although true concordance rates are debatable without open surgical correlation. In the subgroup of 25 patients who had accurate open surgical correlation (from cystectomy, laparotomy or post mortem) the concordance rate was 76% with MRI. Errors occurred mainly in the T3 group of tumours, with 2 being overstaged and 2 being understaged out of a total of 12 in the open surgical correlation group (66% accuracy). Difficulties were also encountered in staging tumours at the bladder base, with an error rate of 22% (2 of 9) for T4 tumours in this area. With regard to lymph node staging there was a 100% (5 of 5) specificity in defining pathologically involved nodes but there was a false negative rate of 15% (3 of 19). Although it has many advantages over CT scanning, MRI produces a significant error rate in terms of over- and under-staging invasive tumours. There are difficulties associated with detecting minimal involvement of adjacent organs and lymph nodes as well as determining the exact depth of muscle penetration. Improvements may come in the future with the use of contrast enhancement agents such as gadolinium as well as more advanced machines.

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Detection and Characterization of Metastatic Cervical Adenopathy by MR Imaging

Cited by 72 publications

References 0 publications

MRI for Pretreatment Lymph Node Staging in Uterine Cervical Cancer

MRI for Pretreatment Lymph Node Staging in Uterine Cervical Cancer

SERPINE1 and SMA expression at the invasive front predict extracapsular spread and survival in oral squamous cell carcinoma

Magnetic Resonance Imaging in the Staging of Bladder Cancer

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