Integrated PET/MRI for whole-body staging of patients with primary cervical cancer: preliminary results

Grueneisen, Johannes; Schaarschmidt, Benedikt Michael; Heubner, Martin; Aktas, Bahriye; Kinner, Sonja; Forsting, Michael; Lauenstein, Thomas C.; Ruhlmann, Verena; Umutlu, Lale

doi:10.1007/s00259-015-3131-5

Cited by 95 publications

(86 citation statements)

References 32 publications

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“…However, several dedicated imaging centres, report high TVUS accuracy for cervical cancer staging and assessment of parametrial involvement, comparable to those of MRI [22,23] . Hybrid imaging (PET-CT or PET-MRI) is superior to conventional cross-sectional techniques for identifying metastatic lymph nodes, with excellent diagnostic accuracy, ranging from 85%-99% [24,25] . However, its role in the initial evaluation of cervical cancer has not been established.…”

Section: Parametrial Involvementmentioning

confidence: 99%

“…Accuracy of PET-CT for local staging of cervical cancer is moderate (53.3%). PET-MRI may be promising for the assessment of primary tumor, with sensitivity and specificity values over 90%, but further studies with larger patient populations are needed to support clinical implementation [25] . MRI is the preferred imaging modality for evaluating local extent of cervical cancer due to its high contrast resolution which enables differentiation between cancerous and normal tissues [5,26,27] .…”

Section: Parametrial Involvementmentioning

confidence: 99%

See 1 more Smart Citation

Current imaging strategies for the evaluation of uterine cervical cancer

Bourgioti

Chatoupis

Moulopoulos

2016

WJR

105

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Uterine cervical cancer still remains an important socioeconomic issue because it largely affects women of reproductive age. Prognosis is highly depended on extent of the disease at diagnosis and, therefore, accurate staging is crucial for optimal management. Cervical cancer is clinically staged, according to International Federation of Gynecology and Obstetrics guidelines, but, currently, there is increased use of cross sectional imaging modalities [computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography-CT (PET-CT)] for the study of important prognostic factors like tumor size, parametrial invasion, endocervical extension, pelvic side wall or adjacent/distal organs involvement and lymph node status. Imaging indications also include cervical cancer follow-up, evaluation of tumor response to treatment and selection of suitable candidates for less radical surgeries like radical trachelectomy for fertility preservation. The preferred imaging method for local cervical cancer evaluation is MRI; CT is equally effective for evaluation of extrauterine spread of the disease. PET-CT shows high diagnostic performance for the detection of tumor relapse and metastatic lymph nodes. The aim of this review is to familiarize radiologists with the MRI appearance of cervical carcinoma and to discuss the indications of cross sectional imaging during the course of the disease in patients with cervical carcinoma.

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Section: Parametrial Involvementmentioning

confidence: 99%

Section: Parametrial Involvementmentioning

confidence: 99%

Current imaging strategies for the evaluation of uterine cervical cancer

Bourgioti

Chatoupis

Moulopoulos

2016

WJR

105

View full text Add to dashboard Cite

show abstract

“…Therefore, an accurate staging and detection of LNs metastases is essential to ensure appropriate treatment planning and prediction of prognosis for cervical cancer patients [5] .…”

mentioning

confidence: 99%

A Comprehensive Comparison of CT, MRI, Positron Emission Tomography or Positron Emission Tomography/CT, and Diffusion Weighted Imaging-MRI for Detecting the Lymph Nodes Metastases in Patients with Cervical Cancer: A Meta-Analysis Based on 67 Studies

Liu

Gao²,

Li³

2017

Gynecol Obstet Invest

172

105

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Object: In recent times, many published papers reported the diagnostic performance of CT, MRI, positron emission tomography (PET) using 2-[¹⁸F] fluoro-2-deoxy-D-glucose (FDG) and diffusion-weighted magnetic resonance imaging (DW-MRI) for detecting the lymph nodes (LNs) metastases in patients with cervical cancer. This study is aimed at assessing and comparing the diagnostic value of those non-invasive modalities in detecting the LNs metastases in cervical cancer patients. Methods: Studies on the non-invasive modalities for the detection of metastatic LNs were searched in PubMed, Medline, Web of Science, Cochrane Library and Embase databases. Pooled positive likelihood ratios and negative likelihood ratios, diagnostic OR, area under curve (AUC), summary receiver operating characteristics were calculated as evaluation indices. Results: In region- or node-based analysis, the AUC of DWI-MRI (0.92) and PET or PET/CT (0.90) were better than CT (0.83), and the difference was significant (DWI-MRI vs. CT: Z = 4.61, p < 0.001; PET or PET/CT vs. CT: Z = 3.61, p = 0.001). Conclusion: Among the 4 non-invasive modalities, the PET or PET/CT has the highest specificity, and DWI-MRI has the highest sensitivity.

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“…General expectations for PET/MRI are high. A recent study assessed the efficacy of integrated PET/MRI for the whole body staging of patients with primary CC (31). In their preliminary results, the authors concluded that integrated PET/MRI had a high potential to accurately assess primary tumors and detect LNM in patients with CC.…”

Section: Discussionmentioning

confidence: 99%

[18F]FDG-PET/CT and MRI for initial pelvic lymph node staging in patients with cervical carcinoma: The potential usefulness of [18F]FDG-PET/MRI

et al. 2018

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Abstract. The current study aimed to determine the optimum diagnostic imaging technique out of magnetic resonance imaging (MRI), 18 F-f ludeoxyglucose positron emission tomography/computed tomography ([ 18 F] FDG-PET/CT, otherwise known as PET/CT) and [18 F] FDG-PET/MRI (otherwise known as PET/MRI) for the pelvic lymph node staging (N-staging) of untreated cervical carcinoma (CC). A total of 27 patients were included in the present study. All patients had undergone pre-treatment with PET/CT and MRI ≤45 days prior to undergoing a lymphadenectomy. The results from PET (separated from PET/CT), MRI and the statistically combined results of (virtual) PET/MRI were compared to those from histological analyses (the gold standard). A per-patient-based analysis of the detection of pelvic lymph node metastases indicated that PET/MRI had a sensitivity of 64%. The specificity of PET/CT and MRI were 69 and 62%, respectively. The positive predictive value (PPV) was 69 and 64% for PET/CT and MRI, respectively. The negative predictive value (NPV) was 64 and 62% for PET/CT and MRI, respectively. The sensitivity of the PET-guided PET/MRI and the MRI-guided PET/MRI was 64% for both. The specificity of the PET-guided PET/MRI and the MRI-guided PET/MRI was 77 and 62%, respectively. The PPV was 75% for PET-guided PET/MRI and 64% for MRI-guided PET/MRI, and the NPV was 67 and 62%, respectively. PET/CT and the virtual PET/MRI exhibited the same low sensitivity (64%). PET/MRI exhibited slightly better results than PET/CT regarding specificity (77 vs. 69%, respectively), PPV (75 vs. 69%, respectively) and NPV (67 vs. 64%, respectively). The results of the present study suggested that PET/CT and MRI are not optimal diagnostic modalities, and that PET/MRI does not necessarily lead to better results than PET/CT, in the pelvic N-staging of CC.

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Integrated PET/MRI for whole-body staging of patients with primary cervical cancer: preliminary results

Cited by 95 publications

References 32 publications

Current imaging strategies for the evaluation of uterine cervical cancer

Current imaging strategies for the evaluation of uterine cervical cancer

A Comprehensive Comparison of CT, MRI, Positron Emission Tomography or Positron Emission Tomography/CT, and Diffusion Weighted Imaging-MRI for Detecting the Lymph Nodes Metastases in Patients with Cervical Cancer: A Meta-Analysis Based on 67 Studies

[18F]FDG-PET/CT and MRI for initial pelvic lymph node staging in patients with cervical carcinoma: The potential usefulness of [18F]FDG-PET/MRI

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