Diagnostic Accuracy of MRI in Primary Cervical Cancer

Rigon, Giuliano; Vallone, Cristina; Starita, Andrea; Vismara, Marco Flavio Michele; Ialongo, Pasquale; Putignani, Lorenza; Signore, Fabrizio

doi:10.4236/ojrad.2012.21003

Cited by 7 publications

(4 citation statements)

References 43 publications

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“…MRI has limited value in the differentiation of metastatic lymph nodes from hyperplasia, in detecting microinvasion in nonenlarged lymph nodes, and for the evaluation of cervical stroma [26, 27]. The limitation in the evaluation of primary tumour size in MRI also includes the impossibility of margin definition, confusing with peritumoral reactions or scars and small tumours (< 1 cm), which might be only visualised on early dynamic contrast-enhanced sequence (DCE) MRI as enhanced foci [28, 29].…”

Section: Discussionmentioning

confidence: 99%

The effect of different segmentation methods on primary tumour metabolic volume assessed in 18F-FDG-PET/CT in patients with cervical cancer, for radiotherapy planning

Cegła

Burchardt

Wierzchoslawska

et al. 2019

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IntroductionGynaecological cancers, including cervical cancer, often require a multidisciplinary approach that includes external beam radiotherapy, chemotherapy, and/or surgical treatment. Biological parameters of the tumour evaluated in 18F-FDG-PET/CT are used for target volume delineation in radiotherapy planning. The choice of segmentation method may affect the assessment of metabolic tumour volume (MTV) in 18F-FDG-PET/CT.Aim of the studyTo find the optimal segmentation method for the assessment of primary MTV in 18F-FDG-PET/CT in cervical cancer patients for radiotherapy planning.Material and methodsRetrospective analysis was performed on a group of 30 patients with newly diagnosed, histologically confirmed cervical cancer. The primary MTVs were assessed by SUVmax and SUVmean values; three segmentation methods were used to assess the primary MTV: constant threshold of SUVmax of 2.5, threshold of SUVmax 35%, and threshold of SUV max 45%. The MTVs were compared with the tumour volumes obtained in magnetic resonance imaging (MRI), which was the “gold standard”, to select the best optimal segmentation method reflecting the tumour size. Wilcoxon-Mann-Whitney and t-test were used for statistical analysis.ResultsDepending on the segmentation method chosen, significant differences in the MTVs were obtained (p < 0.001). The highest volumes were obtained using the method based on constant SUVmax of 2.5, while the smallest in case of threshold of SUVmax of 45%. Regarding the volume determined by MRI, a 35% SUVmax threshold was chosen as the most reliable method.ConclusionsThe choice of appropriate segmentation method has a significant impact on the primary MTV assessment in 18F-FDG-PET/CT in patients with cervical cancer.

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Section: Discussionmentioning

confidence: 99%

The effect of different segmentation methods on primary tumour metabolic volume assessed in 18F-FDG-PET/CT in patients with cervical cancer, for radiotherapy planning

Cegła

Burchardt

Wierzchoslawska

et al. 2019

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“…But they also say that MRI is much better for myometrial and endometrial involvement and is not sensitive enough to replace histopathology. (8) In some studies MRI has shown better accuracy than clinical examination. (9) LIMITATIONS: Since MRI has definite advantage over CT, comparison would have been ideal between MRI and clinical examination.…”

Section: Parametrial Involvement Numbermentioning

confidence: 99%

Accuracy of Clinical Examination in Assessing Parametrium in Cervical Carcinoma

Menon¹

2015

jebmh

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Carcinoma cervix (ca cervix) in early stages can be managed either by surgery or radiation. Surgery has an upper hand in most, especially young ones. Parametrial involvement is one of the most important factor which affect therapeutic choice. Clinical examination was the time tested method for parametrial assessment. Recently use of imaging has started to take an upper hand, which might affect the treatment. AIMS: To find out clinical accuracy in assessing parametrium in early stage ca cervix and to compare with efficacy of CT (computed tomography) scan. MATERIALS AND METHODS: 35 cases of early stage carcinoma cervix who underwent Werthiem's hysterectomy in a cancer research Centre in Kerala were included. All underwent CT scan pre operatively. Accuracy was assessed according to histopathology report. RESULTS AND CONCLUSION: Of the 35 cases without any clinically detectable parametrial involvement only 3 cases had actual paramertial involvement as per histopathology, with a diagnostic accuracy of 91.42%. CT scan even though had a 100% negative predictive value, had only 16.6 % positive predictive value. Hence clinical assessment of parametrium by an experienced person is superior to CT scan and should be relayed upon in case of disparity between the two.

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“…The development of medical technology in recent decades, especially imaging technology, created a paradigm of imaging technology as a vital part of cancer management. In 2018, FIGO had revised its guidelines of cervical cancer, recommending imaging modalities as an additional examination to further guide clinician in diagnosis and treatment choice 7,8 .…”

Section: Introductionmentioning

confidence: 99%

Postradiotherapy Outcome on Cervical Cancer Stage IIIB Patients with and without Paraaortic Lymph Nodes Enlargement

Kusuma

Matondang

Nuranna

et al. 2021

Indones J Obstet Gynecol

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Objective : To determine whether there are differences in clinical response after radiotherapy and 1 year survival in patients with advanced cervical cancer with and without enlargement of PALN.Method : An observational analytic study using a retrospective cohort method was done using consecutive sampling. The subjects of this study were all women with a primary diagnosis of stages IIB to IVB cervical cancer who came to the gynecological oncology clinic of Dr. Cipto Mangunkusumo National General Hospital and underwent MRI examination before undergoing treatment in January 2016 to May 2017Results: Among 76 subjects studied, there were 4 (5.1%) subjects who had enlarged PALN. There were no significant differences between the enlargement status of PALN and age (p = 0.829), age of first sexual intercourse (p = 0.33), parity (p = 0.642), mass diameter (p = 0.777). Patients with PALN enlargement have 2.13 times risk of having negative radiotherapy outcome (p = 0.02, OR 2.13, CI95% 1.12 – 4.07). There was no difference in 1-year survival between patients with and without enlargement of PALN (median 201 vs. 293, p = 0.072).Conclusion: Patients with PALN enlargement have increased risk of having negative radiotherapy outcome (p < 0.05). There were no differences in 1 year survival between patients with advanced cervical cancer with enlargement PALN.Keywords : cervical cancer, lymph node enlargement, paraaortic, radiotherapy. Abstrak Tujuan: Mengetahui adakah perbedaan respon klinis pascaradioterapi dan kesintasan 1 tahun pada pasien kanker serviks stadium lanjut dengan pembesaran KGB paraaorta dibandingkan tanpa pembesaran KGB paraaorta.Metode: Penelitian ini merupakan penelitian analitik observasional dengan menggunakan metode kohort retrospektif. Pengambilan sampel dilakukan dengan cara pengambilan sampel berturut-turut. Subyek penelitian ini adalah semua perempuan dengan diagnosis primer kanker serviks stadium IIB hingga IVB yang datang ke poliklinik Onkologi Ginekologi RSUPN Dr. Cipto Mangunkusumo dan menjalani pemeriksaan MRI sebelum dilakukan terapi pada bulan Januari 2016 hingga Mei 2017.Hasil: Dari 76 subjek yang diteliti, didapatkan sebanyak 4 (5,1%) subyek yang mengalami pembesaran KGB paraaorta. Tidak didapatkan perbedaan yang bermakna antara status pembesaran KGB paraaorta dan usia (p = 0,829), usia hubungan seksual pertama (p = 0,333), paritas (p = 0,642), dan diameter massa (p = 0,777). Pasien dengan pembesaran KGB paraaorta memiliki risiko 2,13 kali lipat (p = 0,02, OR 2,13, IK95% 1,12-4,07) memiliki risiko respon terapi negatif. Tidak terdapat perbedaan kesintasan 1 tahun antara pembesaran KGB paraaorta dan tidak (median 201 vs. 293, p = 0,072).Kesimpulan Pasien dengan pembesaran KGB paraaorta memiliki risiko lebih tinggi mengalami respon radioterapi negatif. (p < 0,05). Tidak terdapat kesintasan 1 tahun antara pasien kanker serviks stadium lanjut dengan dan tanpa pembesaran KGB.Kata kunci: kanker serviks, paraaorta, pembesaran KGB, radioterapi.

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Diagnostic Accuracy of MRI in Primary Cervical Cancer

Cited by 7 publications

References 43 publications

The effect of different segmentation methods on primary tumour metabolic volume assessed in 18F-FDG-PET/CT in patients with cervical cancer, for radiotherapy planning

The effect of different segmentation methods on primary tumour metabolic volume assessed in 18F-FDG-PET/CT in patients with cervical cancer, for radiotherapy planning

Accuracy of Clinical Examination in Assessing Parametrium in Cervical Carcinoma

Postradiotherapy Outcome on Cervical Cancer Stage IIIB Patients with and without Paraaortic Lymph Nodes Enlargement

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