FDG-PET/MRI with high-resolution DWI characterises the distinct phenotypes of endometrial cancer

Tsuyoshi, Hideaki; Tsujikawa, Tetsuya; Yamada, Shizuka; Chino, Yoko; Shinagawa, Akiko; Kurokawa, Tetsuji; Okazawa, Hidehiko; Yoshida, Yoshio

doi:10.1016/j.crad.2019.10.018

Cited by 12 publications

(8 citation statements)

References 26 publications

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Section: Discussionmentioning

confidence: 99%

“…Only two studies [35,36] investigated the diagnostic accuracy of fully-integrated 18F-FDG PET/MRI in population of patients affected by only endometrial cancer; the remaining studies included the assessment of heterogenous gynaecological malignancies. Tsuyoshi et al [35], reported a diagnostic accuracy of 91.3% of 18F-FDG PET/MRI in staging lymph node involvement in a population of 36 patients with endometrial cancer. Bian et al [36] retrospectively reported a sensitivity of 100% for 18F-FDG PET/MRI in detecting the primary tumor and an accuracy of 81.8% in delineating myometrial invasion; the slightly higher percentage of detection compared to our results may be related to the retrospective design of the study [36].…”

Section: Discussionmentioning

confidence: 99%

“…VI, TLG, and SUV max /ADC mean ratio derived from distinct MRI and PET scans predict MI and lymph node involvement or disease recurrence. 22,27,[33][34][35] Only 2 studies 36,37 investigated the diagnostic accuracy of fully integrated 18 F-FDG PET/MRI in population of patients affected by only EC; the remaining studies included the assessment of heterogenous gynecological malignancies. Tsuyoshi et al 37 detecting the primary tumor and an accuracy of 81.8% in delineating MI; the slightly higher percentage of detection compared with our results may be related to the retrospective design of the study.…”

Section: Discussionmentioning

confidence: 99%

“…22,27,[33][34][35] Only 2 studies 36,37 investigated the diagnostic accuracy of fully integrated 18 F-FDG PET/MRI in population of patients affected by only EC; the remaining studies included the assessment of heterogenous gynecological malignancies. Tsuyoshi et al 37 detecting the primary tumor and an accuracy of 81.8% in delineating MI; the slightly higher percentage of detection compared with our results may be related to the retrospective design of the study. The predictive role of tumor size in patients with EC has been also previously demonstrated.…”

Section: Discussionmentioning

confidence: 99%

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Hybrid PET/MRI in Staging Endometrial Cancer

et al. 2022

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Purpose. Assessment of deep myometrial invasion (MI) and lymphovascular space invasion (LVSI) is of utmost importance in preoperative staging of endometrial cancer (EC). Imaging parameters derived respectively from MRI and PET have shown good predictive value. Aim of the present study is to assess the diagnostic performance of hybrid 18F-FDG PET/MRI in EC staging, with particular focus on MI and LVSI detection.Methods. Prospective monocentric study including 35 patients with biopsy-proven EC undergoing preoperative 18F-FDG PET/MRI for staging purpose. Histological examination was the reference standard. PET (SUVmax, SUVmean40, MTV40, TLG40) and MRI (volume index-VI, total tumor volume-TTV, tumor volume ratio-TVR, ADCmean, ADCmin) parameters were calculated on the primary tumor, and their role in predicting histological ndings (grade, high-vs. low-risk groups, LVSI, MI, p53 hyperexpression) was assessed through a ROC analysis.Results. 18F-FDG-PET/MRI identi ed the primary tumor in all patients. In the LVSI detection, PET/MRI demonstrated high accuracy, speci city and negative predictive value (sensitivity=0.8571, speci city=0.9286, accuracy=0.9143, NPV=0.9630, PPV=0.7500). Assessment of MI using PET/MRI correctly staged 27 patients, showing a good positive predictive value (77.1%; sensitivity= 0.7273, speci city=0.8462, accuracy=0.7714, PPV=0.8889, NPV=0.647). VI, TTV, and TVR signi cantly predicted risk groups (p=0.0059, 0.0235, 0.0181, respectively). VI, TTV, TVR, MTV40 and TLG40 signi cantly predicted LVSI (p=0.0023, 0.0068, 0.0068, 0.0027, 0.0139, respectively). Imaging was not able to predict grading, MI nor p53 hyper-expression.Conclusion. 18F-FDG-PET/MRI has good accuracy in preoperative staging of EC; PET and MRI parameters have synergic role in preoperatively predicting LVSI, with MRI parameters being also predictive for EC risk groups.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Hybrid PET/MRI in Staging Endometrial Cancer

et al. 2022

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“…Recent advances included the applications based on integrated functional biologic parameters, such as the SUV to apparent diffusion coefficient (derived from DW-MRI) ratio [67] or PET-intravoxel incoherent motion MRI, which could define an optimal prognostic parameter in EC patients [68,69].…”

Section: The Prognostic Value Of 18f-fdg Pet/ctmentioning

confidence: 99%

The role of 18F-FDG PET/CT in endometrial adenocarcinoma: a review of the literature and recent advances

Garau

Asabella

Ferrari

et al. 2020

Clin Transl Imaging

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Purpose To provide a substantial coverage on the role of 18F-FDG PET/CT in endometrial cancer (EC), and identify the key issues which make its use recommended with both low level of evidence and low strength of recommendation in accordance with the last consensus conference. Methods A comprehensive literature computer search was performed on PubMed/MEDLINE and Cochrane Library databases up to June 2020. Included studies had to focus on 18F-FDG PET/CT in EC, with regard to staging, follow-up and prognostic value. Review guidelines, systematic review, meta-analyses and original papers were included. ResultsThe 18F-FDG PET/CT is affected by suboptimal soft tissue differentiation, with sensitivity and specificity in tumor staging ranged from 77 to 85% and 79 to 96%. The sensitivity and the specificity of 18F-FDG PET/CT performed at staging for lymph node metastases ranged from 63 to 73% and 96 to 97%. For distant metastases, sensitivity and specificity of 18F-FDG PET/CT performed at staging ranged from 63 to 80% and 93 to 96%. After treatment, better performance emerged for EC recurrent with sensitivity ranged from 92 to 98% and specificity ranged from 89 to 94%. Maximum standardized uptake value (SUVmax) and metabolic volumetric parameters, such as total lesion glycolysis (TLG) and metabolic tumor volume (MTV), resulted to be significantly related to prognosis. Conclusion Despite evidence-based data about the diagnostic performance are increasing, the low sensitivity represents the main limitation of 18F-FDG PET/CT imaging utilization for the detection of primary tumor and lymph node metastases. Better performances were observed for distant metastasis and EC recurrence. Further randomized prospective studies are needed to increase both the low level of evidence and low strength of recommendation for using 18F-FDG PET/CT in EC. Promising results emerged from PET/MRI.

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Preoperative Imaging Evaluation of Endometrial Cancer in FIGO 2023

Kido,

Himoto,

Kurata

et al. 2023

Magnetic Resonance Imaging

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The staging of endometrial cancer is based on the International Federation of Gynecology and Obstetrics (FIGO) staging system according to the examination of surgical specimens, and has revised in 2023, 14 years after its last revision in 2009. Molecular and histological classification has incorporated to new FIGO system reflecting the biological behavior and prognosis of endometrial cancer. Nonetheless, the basic role of imaging modalities including ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography, as a preoperative assessment of the tumor extension and also the evaluation points in CT and MRI imaging are not changed, other than several point of local tumor extension. In the field of radiology, it has also undergone remarkable advancement through the rapid progress of computational technology. The application of deep learning reconstruction techniques contributes the benefits of shorter acquisition time or higher quality. Radiomics, which extract various quantitative features from the images, is also expected to have the potential for the quantitative prediction of risk factors such as histological types and lymphovascular space invasion, which is newly included in the new FIGO system. This article reviews the preoperative imaging diagnosis in new FIGO system and recent advances in imaging analysis and their clinical contributions in endometrial cancer.Evidence Level4Technical EfficacyStage 3

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FDG-PET/MRI with high-resolution DWI characterises the distinct phenotypes of endometrial cancer

Cited by 12 publications

References 26 publications

Hybrid PET/MRI in Staging Endometrial Cancer

Hybrid PET/MRI in Staging Endometrial Cancer

The role of 18F-FDG PET/CT in endometrial adenocarcinoma: a review of the literature and recent advances

Preoperative Imaging Evaluation of Endometrial Cancer in FIGO 2023

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