Role of Dynamic Contrast Enhanced MRI and DWI in the Pre-operative Assessment of Endometrial & Cervical Carcinoma

Abstract

Purpose of this study is : To assess the efficacy of dynamic contrast enhanced MRI and diffusion weighted imaging in the preoperative assessment & staging of endometrial & cervical carcinoma and accordingly stratification of best treatment options. Methods The study included 40 patients having uterine malignancy 20 with endometrial carcinoma and 20 with cervical carcinoma (between 32 and 76 years) referred from Gynecologists to Radiodiagnosis Department after histologic diagnosis. Each patient was subjected to full history taking, routine laboratory investigations, preliminary trans-vaginal ultrasound and MR examination including: Conventional MRI, DCE-MRI and DWI. All cases were staged with the aid of T2WIs, DCE-MRI & DWI. Technique was performed using a standard 1.5 Tesla unit (Acheiva, Philips). Results The study showed that DCE-MRI & DWI improve the accuracy of T2WI in staging of endometrial & cervical cancer. Conclusion Using DCE-MRI & DWI improves differentiation of tumor & non-tumor tissue in cervical and endometrial cancer, thus improves the accuracy of pre-surgical mapping, assessment of treatment response and prediction of treatment outcome. That will be without increasing the expected morbidity from unnecessary procedures and accordingly increase the overall patient’s survival.

Diagnostic Accuracy of 18F-FDG-PET/CT and MRI in Predicting the Tumor Response in Locally Advanced Cervical Carcinoma Treated by Chemoradiotherapy: A Meta-Analysis

“…PET has been used to evaluate pretreatment situation and daily surveillance of patients with cervical cancer after treatment [ 11 ]. 3-month posttreatment PET can be applied to predict the therapeutic response [ 12 ]. However, patients who have a poor response to CRT can be detected as soon as possible, and their treatment plan can be changed as well, provided that the tumor response can be estimated during or just after concomitant chemoradiotherapy.…”