Localized cervical cancer (stage &lt;IIB): accuracy of MR imaging in planning less extensive surgery

Manfredi, Riccardo; Gui, Benedetta; Giovanzana, A; Marini, Stefania; Stefano, M. Di; Zannoni, GF; Scambia, Giovanni; Bonomo, Lorenzo

doi:10.1007/s11547-009-0397-3

Cited by 23 publications

(11 citation statements)

References 30 publications

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“…A meta-analysis of four studies carefully selected for IO involvement showed that the estimates of specificity and NPV were 91% and 99%, respectively 14 ; however, the four studies 15–18 that were included in this analysis did not measure the actual distance of the tumour from the IO. 14 A recent retrospective study, 19 measured the distance from the IO on MRI and based the involvement of the IO on the patient's outcome (hysterectomy).…”

Section: Discussionmentioning

confidence: 99%

Is MRI helpful in assessing the distance of the tumour from the internal os in patients with cervical cancer below FIGO Stage IB2?

et al. 2016

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Aim To determine the ability of magnetic resonance imaging (MRI) in detecting tumour-free margins from the internal os (IO). Materials and Methods A database search yielded 79 women with early-stage cervical cancer who underwent radical hysterectomy and preoperative MRI. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of MRI in assessment of ≤5 and >5 mm IO involvement were calculated with histopathological surgical specimen findings considered to be the reference standard. A main and subset analysis was performed. The subset analysis included only those patients who would have been considered for radical trachelectomy. Results For predicting a distance between the tumour and the IO of ≤5 mm, MRI had a sensitivity of 73%, a specificity of 98.3%, a PPV of 95%, a NPV of 88.1%, and an accuracy of 89.8% for the main analysis, and sensitivity of 81.8%, a specificity of 93.2% a PPV of 69.2% a NPV of 96.5% and an accuracy of 91.4% for the subset analysis. Conclusion MRI has high specificity, NPV, and accuracy in detecting tumour from the IO, making MRI suitable for treatment planning in patients desiring trachelectomy to preserve fertility.

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Section: Discussionmentioning

confidence: 99%

Is MRI helpful in assessing the distance of the tumour from the internal os in patients with cervical cancer below FIGO Stage IB2?

et al. 2016

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“…Nonostante ciò, le immagini morfologiche standard (immagini pesate in T1 e T2, con o senza la somministrazione di mezzo di contrasto) sono ancora necessarie per rispondere a specifi che domande, come il coinvolgimento dei parametri, dell'endocervice, dei fornici vaginali e dei linfonodi [29], come anche nel dare informazioni sul volume tumorale e sui dettagli anatomici dell'infi ltrazione di strutture adiacenti, soprattutto in pazienti candidate alla chirurgia e alla radioterapia [30].…”

Section: Discussionunclassified

“…Nevertheless, the usual morphological images (T2-and T1-weighted images, with or without administration of contrast medium) were still necessary to address specifi c questions, such as involvement of parametria, endocervix, vaginal fornices and lymph nodes [29], as well as to give information about tumour volume and anatomical details of infi ltration of adjacent structures in patients for whom surgery or radiotherapy is planned [30].…”

Section: Discussionmentioning

confidence: 99%

Diffusion-weighted MR imaging in assessing cervical tumour response to nonsurgical therapy

et al. 2011

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“…In stage IIB cervical cancer, MRI had 91% diagnostic accuracy, 67% sensitivity, and 92% specificity in assessing infiltration of the vaginal fornices, and 89% diagnostic accuracy, 28% sensitivity, and 100% specificity in the assessment of the lymph nodes, with a cutoff value of 1 cm 11. However, both CT and MRI cannot show the primary tumor’s metabolic characteristics, while FDG PET can provide information concerning the metabolic activity of a tissue region.…”

Section: Discussionmentioning

confidence: 99%

Comparison of imaging-based gross tumor volume and pathological volume determined by whole-mount serial sections in primary cervical cancer

Zhang

Hu²,

Li³

et al. 2013

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ObjectiveTo investigate the accuracy of imaging-based gross tumor volume (GTV) compared with pathological volume in cervical cancer.MethodsTen patients with International Federation of Gynecology and Obstetrics stage I–II cervical cancer were eligible for investigation and underwent surgery in this study. Magnetic resonance imaging (MRI) and fluorine-18 fluorodeoxyglucose positron emission tomography (18F-FDG PET)/computed tomography (CT) scans were taken the day before surgery. The GTVs under MRI and 18F-FDG PET/CT (GTV-MRI, GTV-PET, GTV-CT) were calculated automatically by Eclipse treatment-planning systems. Specimens of excised uterine cervix and cervical cancer were consecutively sliced and divided into whole-mount serial sections. The tumor border of hematoxylin and eosin-stained sections was outlined under a microscope by an experienced pathologist. GTV through pathological image (GTV-path) was calculated with Adobe Photoshop.ResultsThe GTVs (average ± standard deviation) delineated and calculated under CT, MRI, PET, and histopathological sections were 19.41 ± 11.96 cm3, 12.66 ± 10.53 cm3, 11.07 ± 9.44 cm3, and 10.79 ± 8.71 cm3, respectively. The volume of GTV-CT or GTV-MR was bigger than GTV-path, and the difference was statistically significant (P < 0.05). No significant difference was observed between GTV-PET and GTV-path (P > 0.05). Spearman correlation analysis showed that GTV-CT, GTV-MRI, and GTV-PET were significantly correlated with GTV-path (P < 0.01). There was no significant difference in the lesion coverage factor among the three modalities.ConclusionThe present study showed that GTV defined under 40% of maximum standardized uptake value in PET images was very similar to the pathological volume of cervical cancer. This result should be replicated in a larger number of patients with cervical cancer in a future study of ours.

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Localized cervical cancer (stage <IIB): accuracy of MR imaging in planning less extensive surgery

Abstract: MR imaging had a high level of accuracy in the preoperative assessment of the extent of cervical tumour in patients eligible for conservative surgery. Accuracy is lower in the evaluation of the pelvic and lumboaortic lymph nodes.

Cited by 23 publications

References 30 publications

Is MRI helpful in assessing the distance of the tumour from the internal os in patients with cervical cancer below FIGO Stage IB2?

Is MRI helpful in assessing the distance of the tumour from the internal os in patients with cervical cancer below FIGO Stage IB2?

Diffusion-weighted MR imaging in assessing cervical tumour response to nonsurgical therapy

Comparison of imaging-based gross tumor volume and pathological volume determined by whole-mount serial sections in primary cervical cancer

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