Diagnostic Performance of Nanoparticle-Enhanced Magnetic Resonance Imaging in the Diagnosis of Lymph Node Metastases in Patients With Endometrial and Cervical Cancer

Rockall, Andrea; Sohaib, S.A.; Harisinghani, Mukesh G.; Babar, Syed; Singh, Naveena; Jeyarajah, Arjun; Oram, David; Jacobs, Ian; Shepherd, John H.; Reznek, Rodney H.

doi:10.1200/jco.2005.07.166

Cited by 320 publications

(163 citation statements)

References 22 publications

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“…Pathologic examination did not reveal any particular feature except for a discrete capsular thickening but devoid of metastasis. This suggests that this pattern of nodal enhancement should also be viewed as a pattern variant for normal enhancement and not as a sign of metastatic involvement, as it was previously pointed out by Rockall et al (30) when evaluating pelvic lymph nodes in patients with gynecological cancers. Inflammatory nodes can also show a reduced uptake of USPIO due to hyperplasia of the germinal centers and paucity in macrophages as occurred in one of our cases.…”

Section: Discussionmentioning

confidence: 54%

USPIO‐enhanced magnetic resonance imaging for nodal staging in patients with head and neck cancer

Curvo-Semedo

Diniz

Miguéis

et al. 2006

Magnetic Resonance Imaging

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Purpose:To determine the accuracy of ultrasmall superparamagnetic iron oxide (USPIO)-enhanced magnetic resonance imaging (MRI) for nodal staging in patients with head and neck cancer. Materials and Methods:Twenty patients with carcinomas of the upper aerodigestive tract were prospectively enrolled. MRI was performed before and 24 -36 hours after intravenous infusion of an USPIO agent, ferumoxtran-10 (Sinerem; Guerbet, France; and Combidex; Advanced Magnetics) at a dose of 2.6 mg Fe/kg using T2-weighted spin-echo and gradient-echo sequences. Surgery was performed the same day or the day after the ferumoxtran-10 -enhanced MR examination. Based on MRI, selected nodes were surgically removed and directly correlated with pathology using hematoxylin-eosin (H&E) and Perls stainings.Results: A total of 63 nodes were studied; 36 were nonmetastatic, 25 metastatic, and two inflammatory. Ferumoxtran-10 -enhanced MRI allowed diagnosis of 24 metastatic and 30 nonmetastatic nodes, yielding a sensitivity of 96%, a specificity of 78.9%, a positive predictive value of 75%, and a negative predictive value of 96.8%, compared to 64%, 78.9%, 66.6%, and 76.9%, respectively, for nonenhanced MRI. Accuracy of ferumoxtran-10 -enhanced MRI was 85.7%. The gradient-echo T2-weighted sequence was the most accurate to detect signal loss in nonmetastatic nodes.Conclusion: USPIO-enhanced MRI is useful for nodal staging of patients with head and neck cancers. CROSS-SECTIONAL IMAGING plays an important role in the study of patients with head and neck squamous cell carcinomas, allowing detection of lymph nodes (LN) missed by physical examination, or demonstrating invasion of structures such as the skull base or the carotid arteries (1,2). Using these imaging modalities, the criteria for diagnosing metastatic nodes is mainly dimensional. Measurements include the minimum transaxial diameter, the maximum transaxial diameter or a ratio between the maximum longitudinal and the maximum axial diameters (3-7). Other parameters, such as morphological criteria or the pattern of enhancement, are regarded as less important in this setting. Nodal metastases in the head and neck are frequently smaller than 10 mm, sometimes even under 5 mm in diameter, a fact that accounts for the unsatisfactory performance of the current imaging techniques (8,9).MRI can be improved when using contrast agents suited for intravenous MR lymphography, such as the new ultrasmall superparamagnetic iron oxide (USPIO) particles, which are taken up by cells of the reticuloendothelial system of nonmetastatic LN (10 -15). As it has been shown in previous studies, iron oxide deposition leads to a decrease in the signal intensity (SI) in nonmetastatic nodes due to the T2 shortening effects, whereas metastatic nodes, devoid of macrophages, will not undergo SI changes when using T2-weighted sequences (11). The clinical use of this contrast agent is still under evaluation on phase III clinical trials (15)(16)(17)(18)(19)(20). Reports show promising results, with sensitivity and specificity value...

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Section: Discussionmentioning

confidence: 54%

USPIO‐enhanced magnetic resonance imaging for nodal staging in patients with head and neck cancer

Curvo-Semedo

Diniz

Miguéis

et al. 2006

Magnetic Resonance Imaging

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“…They are also promising in comparison to other blood derived biomarkers like Ca 125, imaging methods and clinicopathological risk factors which were reported to predict more advanced disease. [51][52][53] In conclusion, our study revealed that a set of miRNAs was regulated in tissues and plasma of EEC patients. We confirmed expression alterations of several miRNAs that were previously indicated in EEC, which helps to establish a miRNA panel characteristic for this malignancy.…”

Section: Early Detection and Diagnosismentioning

confidence: 99%

Diagnostic and prognostic significance of miRNA signatures in tissues and plasma of endometrioid endometrial carcinoma patients

Torres

Pesci

et al. 2012

Intl Journal of Cancer

132

120

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The aim of our study was to define tissue and plasma miRNA signatures, which could potentially serve as diagnostic and prognostic markers in endometrioid endometrial cancer (EEC) and to investigate miRNA profiles in regard to clinicopathological characteristics. Tissue and plasma samples were collected from 122 women (77 EEC and 45 controls). Expression profiling of 866 human miRNAs and 89 human viral miRNAs was performed in 24 samples and was followed by qPCR validation in 104 patients. Expression of 16 miRNAs was analyzed in 48 plasma samples. Microarray study revealed regulation of 21 miRNAs in EEC tissues comparing to normal endometrium. Altered expression of 17 miRNAs was confirmed by qPCR performed in 104 tissue samples. Seven miRNAs were upregulated and two were downregulated in EEC plasma samples. Endometrial cancer is the fourth most often diagnosed malignancy in the female population of the developed countries and the most common cancer of the female reproductive tract. In 2008, 82,530 endometrial cancer cases were recorded in Europe.1 Estimated number of new cases diagnosed in 2011 in the United States was 46,470 and was higher than in 2010.2 Data deposited in the Polish Cancer Registry indicated a progressive increase in endometrial cancer incidence over the period between 1999 and 2008.3 Similar trend has been observed in Great Britain. 4 Endometrial cancer is a heterogeneous malignancy comprising many histological types, which differ significantly in terms of pathogenesis, clinical presentation and prognosis. Such heterogeneity impedes development of screening and treatment strategies. Despite a great improvement in endometrial cancer treatment and diagnosis, advanced stages of the disease are still difficult to manage with the 5-year survival rate of $10-29%.5 Increase in the incidence of endometrial cancer and the lack of powerful yet nontoxic treatment strategies indicate the need of developing novel diagnostic, prognostic and treatment strategies for this malignancy.

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“…As discussed earlier, CT and conventional MRI have limited accuracy in detecting recurrent nodal disease, and although contrast-enhanced MRI with lymphotropic superparamagnetic nanoparticles appears promising for the detection of lymph node metastases, it has not received regulatory approved in the United States (107). As an alternative to CT or MRI, immunoscintigraphy with capromab is controversial.…”

Section: Post-treatment Detection Of Metastasesmentioning

confidence: 99%

MRI of the prostate: Clinical relevance and emerging applications

Mazaheri

Shukla–Dave

Muellner

et al. 2011

Magnetic Resonance Imaging

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MRI of the prostate can aid in many aspects of prostate cancer management, from initial detection to treatment planning and follow-up. This review describes the current strengths and limitations of conventional anatomic and molecular MR imaging techniques (including MR spectroscopic imaging and dynamic contrast-enhanced imaging) for aiding prostate cancer management. It also describes promising emerging approaches for acquiring, analyzing, and applying MR imaging data, and the major research and educational efforts that will be required to realize the potential of prostate MR imaging in routine clinical practice.

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Diagnostic Performance of Nanoparticle-Enhanced Magnetic Resonance Imaging in the Diagnosis of Lymph Node Metastases in Patients With Endometrial and Cervical Cancer

Abstract: Lymph node characterization with USPIO increases the sensitivity of MRI in the prediction of lymph node metastases, with no loss of specificity. This may greatly improve preoperative treatment planning.

Cited by 320 publications

References 22 publications

USPIO‐enhanced magnetic resonance imaging for nodal staging in patients with head and neck cancer

USPIO‐enhanced magnetic resonance imaging for nodal staging in patients with head and neck cancer

Diagnostic and prognostic significance of miRNA signatures in tissues and plasma of endometrioid endometrial carcinoma patients

MRI of the prostate: Clinical relevance and emerging applications

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