MR Imaging of Uterine Cervical Carcinoma

Waggenspack, Gerard A.; Amparo, Eugenio G.; Hannigan, Edward V.

doi:10.1097/00004728-198805000-00010

Cited by 2 publications

(9 citation statements)

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“…The accuracy and sensitivity rates for MRI are reported to be between 76% and 100% and 36% and 89.5%, respectively [15][16][17][18][19][20][21][22]. In the present study, which used the criterion for metastasis as a lymph node with a short-axis diameter of 9 mm or larger, the accuracy and sensitivity rates for region-specific comparisons were 91.4% and 33.3%, respectively.…”

Section: Discussionmentioning

confidence: 59%

“…Thus, we may have detected metastases that might have been missed using conventional techniques. In addition, the range and completeness of surgical staging were different from other studies in that previous studies did not perform systematic surgical staging, including paraaortic dissection for all cases [15][16][17][18][19][20][21][22].…”

Section: Discussionmentioning

confidence: 91%

“…ranging from 6 to 15 mm have been applied, with 10 mm being the most common criterion for the upper limit of a normal lymph node [15][16][17][18][19][20][21][22]. In the current study, a short-axis diameter of 9 mm was the optimal value using MRI, not only on a region-by-region basis but also on a node-by-node basis.…”

Section: Discussionmentioning

confidence: 95%

“…The only generally accepted MRI criterion in the diagnosis of a metastatic pelvic lymph node is node size [15][16][17][18][19][20][21][22]. Diameter limits a Gadolinium-enhanced T1-weighted MR scans were obtained only for pelvic areas in 45 of 55 patients in this study, and there were 69 metastatic pelvic lymph nodes in those patients.…”

Section: Discussionmentioning

confidence: 99%

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MRI for Pretreatment Lymph Node Staging in Uterine Cervical Cancer

Choi

Kim

Seo

et al. 2006

American Journal of Roentgenology

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WEBThis is a Web exclusive article.OBJECTIVE. The purpose of this article is to assess the accuracy of MRI in detecting pelvic and paraaortic lymph node metastasis from uterine cervical cancer using various imaging criteria.CONCLUSION. Although MRI analysis resulted in relatively low sensitivity, size and margin (spiculated or lobulated) were useful criteria for predicting lymph node metastasis from cervical cancer.ervical cancer is the second most frequently diagnosed malignancy in women worldwide, and it is the only major gynecologic malignancy clinically staged according to International Federation of Obstetrics and Gynecology (FIGO) recommendations [1]. Clinical staging of cervical cancers is accurate in only approximately 60% of cases, which is far less than surgical staging accuracy [2,3]. Lymph node metastasis is not a factor for FIGO staging; however, nodal metastases in gynecologic malignancies have an adverse impact on survival, especially in cases of paraaortic node involvement in cervical cancer [4,5]. Although nodal resection before radiation therapy results in a higher survival rate in patients with grossly enlarged pelvic and paraaortic lymph nodes [6,7], routine pretreatment surgical staging is not recommended. For this reason, inaccurate pretreatment assessment of lymph node involvement can lead to suboptimal treatment [8,9].CT and MRI have been used to assess paraaortic and pelvic lymph nodes in patients with cervical cancer. A meta-analysis of such studies concluded that these methods have only moderate sensitivity and specificity for detecting metastases [10]. These studies relied on the size and shape of lymph nodes, and the analyses were based on region-specific comparisons. It was reported that margin and appearance are valid criteria for assessing lymph node metastasis from rectal cancer [11]. However, to our knowledge, no reports define the validity of criteria other than size and shape, and no reports have described node-by-node comparisons in the detection of metastatic pelvic lymph nodes in patients with uterine cervical carcinoma.The purpose of this study was to assess the accuracy of MRI in detecting metastatic lymph nodes in cervical cancer patients using various imaging criteria. Materials and Methods Patients and Staging WorkupPatients included in this retrospective study were those with histopathologically confirmed FIGO stages IB-IVA invasive cervical cancer, which was determined by a conventional workup that included MRI. Patients were recruited between October 2001 and October 2004, ranged in age from 18 to 65 years (mean age, 48 years), had no contraindications to the surgical procedure, had no evidence of distant metastases, and had an Eastern Cooperative Oncology Group performance status of 0-1. Patients with small cell carcinoma (n = 2) and patients who were not to undergo laparoscopic lymph node dissection (n = 63) were excluded.After histologic confirmation of invasive cervical carcinoma, the FIGO stage was determined using bimanual pelvic examination, excretory urograp...

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

MRI for Pretreatment Lymph Node Staging in Uterine Cervical Cancer

Choi

Kim

Seo

et al. 2006

American Journal of Roentgenology

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“…CT has been of limited value because of its inability to differentiate tumors confined to the cervix (Stage IB) from tumors with parametrial infiltration (Stage IIB) (3,.9, 10, 16, 18), although CT has been advocated as an important adjunct in more advanced disease (10,16,18). Recently, MR imaging has been reported to be fairly accurate in the staging of cervical carcinoma (3,4,8,9,13), although some studies do not agree (1,17,21).…”

mentioning

confidence: 99%