The Role of Computed Tomography and Magnetic Resonance Imaging in Gynecologic Oncology

Laifer-Narin, Sherelle; Genestine, Wendy F.; Okechukwu, Nancy C.; Hecht, Elizabeth M.; Newhouse, Jeffrey H.

doi:10.1016/j.cpet.2017.11.002

Cited by 12 publications

(7 citation statements)

References 48 publications

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“…The Federation Internationale de Gynecologie Et d'Obstetrique (FIGO) staging system of cervical cancer relies mainly on findings at physical examination, which is limited in the evaluation of lymphadenopathy and accurate extent of metastatic disease. Discrepancies between clinical and surgical staging occur in 25% of cervical cancer cases in early stages and 65%-90% of cases in advanced stages (45). MRI is the superior imaging modality for local-regional staging of cervical cancer and is useful in the evaluation of tumor response (46).…”

Section: Invasive Cervical Carcinomamentioning

confidence: 99%

“…In these cases, the proximal end of the lesion must be at minimum 1 cm distal to the internal os. MRI provides sensitivity of 100% and specificity of 96% in the evaluation of the tumor in relation to that of the internal os (45).…”

Section: Invasive Cervical Carcinomamentioning

confidence: 99%

“…MRI also provides a high negative predictive value for parametrial invasion, which can help in the selection of surgical candidates. In advanced cases, parametrial invasion, bladder and rectal involvement, and pelvic lymphadenopathy can be evaluated at MRI (45). However, tumor size can be overestimated at MRI owing to postbiopsy and chronic inflammatory changes and cervical intraepithelial neoplasia.…”

Section: Invasive Cervical Carcinomamentioning

confidence: 99%

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HIV-related Malignancies and Mimics: Imaging Findings and Management

Javadi¹,

Menias²,

Karbasian³

et al. 2018

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The risk of developing malignancy is higher in patients with human immunodeficiency virus (HIV) infection than in non-HIV-infected patients. Several factors including immunosuppression, viral coinfection, and high-risk lifestyle choices lead to higher rates of cancer in the HIV-infected population. A subset of HIV-related malignancies are considered to be acquired immunodeficiency syndrome (AIDS)-defining malignancies, as their presence confirms the diagnosis of AIDS in an HIV-infected patient. The introduction of highly active antiretroviral therapy (HAART) has led to a significant drop in the rate of AIDS-defining malignancies, including Kaposi sarcoma, non-Hodgkin lymphoma, and invasive cervical carcinoma. However, non-AIDS-defining malignancies (eg, Hodgkin lymphoma, lung cancer, hepatocellular carcinoma, and head and neck cancers) now account for an increasing number of cancer cases diagnosed in HIV-infected patients. Although the number has decreased, AIDS-defining malignancies account for 15%-19% of all deaths in HIV-infected patients in the post-HAART era. Most HIVrelated malignancies in HIV-infected patients manifest at an earlier age with a more aggressive course than that of non-HIV-related malignancies. Understanding common HIV-related malignancies and their specific imaging features is crucial for making an accurate and early diagnosis, which impacts management. Owing to the weakened immune system of HIV-infected patients, other entities such as various infections, particularly opportunistic infections, are prevalent in these patients. These processes can have confounding clinical and imaging manifestations that mimic malignancy. This article reviews the most common AIDS-defining and non-AIDS-defining malignancies, the role of imaging in their diagnosis, and the imaging mimics of malignancies in HIV-infected patients. ©

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Section: Invasive Cervical Carcinomamentioning

confidence: 99%

Section: Invasive Cervical Carcinomamentioning

confidence: 99%

Section: Invasive Cervical Carcinomamentioning

confidence: 99%

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HIV-related Malignancies and Mimics: Imaging Findings and Management

Javadi¹,

Menias²,

Karbasian³

et al. 2018

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“…PET-CT is also useful to optimise radiotherapy treatment planning. Despite the better accuracy of PET-CT versus CT alone, up to 32% of patients with confirmed nodal invasion will be classified as negative on PET-CT. 25 The overall sensitivity of PET-CT in detecting metastatic disease is 36%, the overall false-negative rate of para-aortic node involvement is around 12%, mainly attributable to small non-detectable nodes (i.e. when lymph nodes measure <5 mm).…”

Section: Positron Emission Tomography With Ctmentioning

confidence: 99%

The role of para-aortic nodal irradiation in cervical cancer

Chacón

Chávez-Nogueda

Ramos-Prudencio

et al. 2018

Reports of Practical Oncology & Radiotherapy

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The current standard of care for locally advanced cervical cancer is whole pelvis and para-aortic radiation when indicated, delivered concomitantly with chemotherapy and brachytherapy. Para-aortic node involvement is a predictor of survival in locally advanced disease but presence of metastases is difficult to determine because the currently available imaging methods lack enough sensitivity to be able to detect accurately para-aortic metastases when surgical staging is not feasible. The objective of this review is to describe the current status of para-aortic lymph node irradiation in locally advanced cervical cancer. It includes analysis of the diagnostic imaging and surgical approaches for assessment of para-aortic lymph node dissemination, together with indications for radiotherapy and radiotherapeutic techniques.

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“…In this regard, magnetic resonance imaging (MRI) with a superior soft-tissue resolution plays a key role in identifying the nature of lesions in the pelvis and in detecting metastatic lymph nodes (5,6). A contrast-enhanced MRI with the diffusion-weighted and dynamic protocol is useful for diagnosing the stage of the disease and determining its metastasis, especially in the preoperative stages (7,8).…”

Section: Introductionmentioning

confidence: 99%

Diagnostic value of diffusion-weighted magnetic resonance imaging in discriminating between metastatic and non-metastatic pelvic lymph nodes in endometrial cancer

2020

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Background Researchers have recently focused on assessing the accuracy of diffusion-weighted magnetic resonance imaging (DW-MRI) in predicting pelvic lymph node metastases in gynecological malignancies. Purpose To evaluate the diagnostic value of DW-MRI in discriminating between metastatic and non-metastatic pelvic lymph nodes in endometrial cancer patients. Material and Methods This retrospective database study was conducted with 33 women aged 30–84 years with pathologically proven endometrial cancer that had been assessed by DW-MRI before their first treatment initiation at our referral hospital from March 2016 to April 2019. The diffusion technique (b = 50, 400, and 1000 mm2/s) was used in the imaging, and continuous apparent diffusion coefficient (ADC) metrics (ADCmin, ADCmax, ADCmean, ADCSD, and rADC) were compared between the metastatic and non-metastatic lymph nodes. Results In total, 48 lymph nodes from 33 patients were assessed. All metastatic lymph nodes were restricted, while among the non-metastatic lymph nodes, only 19.3% were restricted. Considering pathological reports of metastatic and non-metastatic lymph nodes as the gold standard, DWI-related restricted and non-restricted features had a sensitivity of 80.6%, a specificity of 100%, and an accuracy of 87.5% to discriminate between a metastatic and non-metastatic pattern. ADC metrics of ADCmin, ADCmax, ADCmean, ADCSD, and rADC showed high values enabling differentiation between metastatic and non-metastatic lymph nodes. The best cut-off values were 0.7 × 10−3, 1.2 × 10−3, 1.01 × 10−3, 123, and 0.78, respectively. Conclusion DW-MRI is a useful quantitative tool for differentiating between metastatic and benign lymph nodes in endometrial cancer patients.

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The Role of Computed Tomography and Magnetic Resonance Imaging in Gynecologic Oncology

Cited by 12 publications

References 48 publications

HIV-related Malignancies and Mimics: Imaging Findings and Management

HIV-related Malignancies and Mimics: Imaging Findings and Management

The role of para-aortic nodal irradiation in cervical cancer

Diagnostic value of diffusion-weighted magnetic resonance imaging in discriminating between metastatic and non-metastatic pelvic lymph nodes in endometrial cancer

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