The added benefit of transvaginal sonography in the clinical staging of cervical carcinoma

Goldberg, Yael; Siegler, Yoav; Segev, Yakir; Mandel, R.; Siegler, Efraim; Auslander, Ron; Lavie, Ofer

doi:10.1111/aogs.13750

Cited by 3 publications

(5 citation statements)

References 20 publications

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“…Hence, VGS is more sensitive than MRI in identifying small lesions. Prior studies did not find that TVUS was better than MRI in the detection of lesions <2 cm [ 9 , 20 ]. Only one previous study showed that TRUS was superior to MRI in the identification of very small lesions (<1 cm) [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Vaginosonography versus MRI in Pre-Treatment Evaluation of Early-Stage Cervical Cancer: An Old Tool for a New Precision Approach?

et al. 2022

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This study aims to analyze the sensitivity of vaginosonography (VGS) and magnetic resonance imaging (MRI) in the preoperative local evaluation of early-stage cervical cancers and to assess their accuracy in the detection of tumors, size of the lesions and stromal invasion by comparing them with the final histopathology report. This single-center study included 56 consecutive patients with cervical cancer who underwent VGS and MRI from November 2012 to January 2021. VGS significantly overestimated the lesion size by 2.7 mm (p = 0.002), and MRI underestimated it by 1.9 mm (p = 0.11). Both MRI and VGS had a good concordance with the pathology report (Cohen’s kappa of 0.73 and 0.81, respectively). However, MRI had a false-negative rate (38.1%) that was greater than VGS (0%) in cases of cervical tumor size <2 cm. We found a good concordance between histology and VGS in the stromal infiltration assessment, with 89% sensitivity (95% CI 0.44–0.83) and 89% specificity (95% CI 0.52–0.86). VGS is a simple, inexpensive, widely available, and fast execution method that can complement ultrasound in particular cases and show a good correlation with MRI in the assessment of tumor dimensions, with a better performance in detecting small tumors (<2 cm).

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Section: Discussionmentioning

confidence: 99%

Vaginosonography versus MRI in Pre-Treatment Evaluation of Early-Stage Cervical Cancer: An Old Tool for a New Precision Approach?

et al. 2022

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“…Therefore, the vaginal B-ultrasonography has a certain value on the early cervical cancer screening. MRI characterized by multi-level, multi-directional, multi-sequence imaging, with strong tissue resolution can be used for imaging staging of cervical cancer[ 13 ]. In this case, the MRI of the cervix showed a 3 cm diameter quasi-circular high T2WI signals in the anterior lip of the cervix and the anterior wall of the cervix, with limited diffusion and an ADC value of 0.838 × 10 -3 mm 2 /s, with a markedly enhanced edges during enhanced phrase.…”

Section: Discussionmentioning

confidence: 99%

Coexistence of cervical extramedullary plasmacytoma and squamous cell carcinoma: A case report

Zhang¹,

Li²,

Jiang³

et al. 2021

WJCC

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BACKGROUND Extramedullary plasmacytoma (EMP), a variant form of myeloma, is a rare solid plasma cell tumor that originates from the bone marrow hematopoietic tissue and accounts for about 3% of all plasma cell tumors. EMP can affect various tissues and organs, about 90% of which is found in the head and neck. However, EMP in the reproductive organs is rare, and is difficult to be distinguished from other primary or metastatic genital tumors according to clinical symptoms and imaging findings. CASE SUMMARY Herein, we report a case with coexistence of EMP and squamous cell carcinoma in the cervix. The first histopathological report of neoplasms on the surface of the cervix and vagina showed an EMP. Both ultrasound and pelvic enhanced magnetic resonance imaging (MRI) indicated that there was a tumor in the cervix. Thus, another cervical biopsy and pathological examination were performed, which indicated EMP combined with squamous cell carcinoma. Then, the patient underwent extensive total hysterectomy (type C1) + systemic lymph node dissection and received 25 external pelvic irradiations with a dose of 50 Gy following surgery. During 2-year follow-up, no recurrence was reported. CONCLUSION In conclusion, EMP involving the reproductive system is relatively rare. In this case, MRI, B-ultrasound, and cervical canal scraping were used to further determine the diagnosis of EMP combined with squamous cell carcinoma. The patient had improved prognosis after appropriate treatments.

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“…In another study, a small subset of patients (n = 25) who underwent ultrasonography for preoperative local staging showed 100% concordance between ultrasound and histology after surgery for parametrial involvement. However, the mean maximal cervical lesion diameter was 1.6 cm, and the median age of patients was 44 years [37]. Thus, this cohort represents a highly selective set of candidates for surgical treatment in which parametrial involvement would be extremely rare.…”

Section: Parametriamentioning

confidence: 95%

“…Uterine corpus involvement was not evaluated in previous studies comparing ultrasound and MRI accuracy for staging cervical cancer [2,6,33,37]. Moreover, it has not been incorporated into the FIGO [26] or TNM [1] staging classifications.…”

Section: Uterine Corpus Involvementmentioning

confidence: 99%

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Accuracy of Ultrasonography and Magnetic Resonance Imaging for Preoperative Staging of Cervical Cancer—Analysis of Patients from the Prospective Study on Total Mesometrial Resection

et al. 2021

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We aimed to evaluate the accuracy of ultrasonography with gynecologic examination performed by a gynecological oncologist and magnetic resonance imaging (MRI) interpreted by a radiologist for the local and regional staging of patients with early-stage cervical cancer. The study was a single-site sub-analysis of the multi-institutional prospective, observational Total Mesometrial Resection (TMMR) Register Study, which included all consecutive study patients from Gdynia Oncology Center. Imaging results were compared with pathology findings. A total of 58 consecutive patients were enrolled, and 50 underwent both ultrasonography and MRI. The accuracy of tumor detection and measurement errors was comparable across ultrasonography and MRI. There were no significant differences between ultrasonography and MRI in the accuracy of detecting parametrial involvement (92%, confidence interval (CI) 84–100% vs. 76%, CI 64–88%, p = 0.3), uterine corpus infiltration (94%, CI 87–100% vs. 86%, CI 76–96%, p = 0.3), and vaginal fornix involvement (96%, CI 91–100% vs. 76%, CI 64–88%, p = 0.3). The importance of uterine corpus involvement for the first-line lymph node metastases was presented in few cases. The accuracy of ultrasonography was higher than MRI for correctly predicting tumor stage: International Federation of Gynecology and Obstetrics (FIGO)–2018: 69%, CI 57–81% vs. 42%, CI 28–56%, p = 0.002, T (from TNM system): 79%, CI 69–90% vs. 52%, CI 38–66%, p = 0.0005, and ontogenetic tumor staging: 88%, CI 80–96% vs. 70%, CI 57–83%, p = 0.005. For patients with cervical cancer who are eligible for TMMR and therapeutic lymphadenectomy, the accuracy of ultrasonography performed by gynecological oncologists is not inferior to that of MRI interpreted by a radiologist for assessing specific local parameters, and is more accurate for local staging of the disease and is thus more clinically useful for planning adequate surgical treatment.

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The added benefit of transvaginal sonography in the clinical staging of cervical carcinoma

Cited by 3 publications

References 20 publications

Vaginosonography versus MRI in Pre-Treatment Evaluation of Early-Stage Cervical Cancer: An Old Tool for a New Precision Approach?

Vaginosonography versus MRI in Pre-Treatment Evaluation of Early-Stage Cervical Cancer: An Old Tool for a New Precision Approach?

Coexistence of cervical extramedullary plasmacytoma and squamous cell carcinoma: A case report

Accuracy of Ultrasonography and Magnetic Resonance Imaging for Preoperative Staging of Cervical Cancer—Analysis of Patients from the Prospective Study on Total Mesometrial Resection

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