The value of advanced MRI techniques in the assessment of cervical cancer: a review

Dappa, Evelyn; Elger, Tania; Hasenburg, Annette; Düber, Christoph; Battista, Marco Johannes; Hötker, Andreas M.

doi:10.1007/s13244-017-0567-0

Cited by 105 publications

(64 citation statements)

References 142 publications

(129 reference statements)

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“…There is an emerging role of DWI in tumor restaging after neoadjuvant therapy in different abdominal malignancies such as rectal and cervical cancers [62,63]. PDAC demonstrates high signal intensity on high b-value DWI and lower signal intensity on the apparent diffusion coefficient (ADC) map as compared to the normal parenchyma [64].…”

Section: Imaging Findings After Neoadjuvant Therapymentioning

confidence: 99%

Imaging diagnosis and staging of pancreatic ductal adenocarcinoma: a comprehensive review

2020

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Pancreatic ductal adenocarcinoma (PDAC) has continued to have a poor prognosis for the last few decades in spite of recent advances in different imaging modalities mainly due to difficulty in early diagnosis and aggressive biological behavior. Early PDAC can be missed on CT due to similar attenuation relative to the normal pancreas, small size, or hidden location in the uncinate process. Tumor resectability and its contingency on the vascular invasion most commonly assessed with multi-phasic thin-slice CT is a continuously changing concept, particularly in the era of frequent neoadjuvant therapy. Coexistent celiac artery stenosis may affect the surgical plan in patients undergoing pancreaticoduodenectomy. In this review, we discuss the challenges related to the imaging of PDAC. These include radiological and clinical subtleties of the tumor, evolving imaging criteria for tumor resectability, preoperative diagnosis of accompanying celiac artery stenosis, and post-neoadjuvant therapy imaging. For each category, the key imaging features and potential pitfalls on cross-sectional imaging will be discussed. Also, we will describe the imaging discriminators of potential mimickers of PDAC.

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Section: Imaging Findings After Neoadjuvant Therapymentioning

confidence: 99%

Imaging diagnosis and staging of pancreatic ductal adenocarcinoma: a comprehensive review

2020

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“…The major metastasis pattern for cervical cancer is a direct invasion [18], so resection of parametrical tissues can effectively prevent a pelvic recurrence. However, the prevalent metastasis pattern for endometrial cancer is a lymph-vascular invasion.…”

Section: Discussionmentioning

confidence: 99%

The necessity of radical hysterectomy (RH) for pure endometrial carcinoma combined with cervical involvement: a retrospective cohort study comparing RH with total hysterectomy (TH)

Zhi-min¹,

Chen

et al. 2020

Preprint

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Objective : The purpose of this study was to explore the necessity of radical hysterectomy (RH) for patients with pure endometrial carcinoma（PEC) combined with cervical involvement by comparing with total hysterectomy (TH).Methods : A total of 162 patients who were diagnosed as PEC combined with cervical involvement of stage II and III by postoperative pathological examination between January, 2007 and December, 2017 were included in our study. Among of them, 91 were followed up till the end of this study and 71 were lost in the follow-up. In the 91 patients with complete follow-up information, 34 patients were treated with TH and 57 patients were treated with RH. The 5-year progression free survival rate, 5-year overall survival rate, recurrence rate and postoperative complications of patients were evaluated.Results : There were no significant differences in both the overall survival curve and progression free survival curve between patients with PEC receiving RH and those receiving TH (both p > 0.05). The analysis of postoperative complications showed that patients with RH treatment may have a higher probability of postoperative lymphocyst and urinary dysfunction.Conclusions : RH may not improve the prognosis of cervical involvement in patients with PEC. The postoperative complications of patients with PEC who treated with RH may increase.

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“…At this moment, MRI is widely used for initial local staging and target/OAR delineation and also increasingly used for monitoring treatment response after CRT. However, the accuracy of conventional MRI techniques only (T2 sequences) is less than DW-imaging for monitoring treatment response [ 27 , 28 ]. A clinical and iconographical complete response after CRT predicts a better outcome, whereas macroscopic residual disease at the HRT specimen is an adverse prognostic factor for survival [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

EXclusion of non-Involved uterus from the Target Volume (EXIT-trial): an individualized treatment for locally advanced cervical cancer using modern radiotherapy and imaging techniques

et al. 2018

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BackgroundDefinitive chemoradiotherapy is standard of care in locally advanced cervical cancer (LACC). Both toxicity and local relapse remain major concerns in this treatment. We hypothesize that a magnetic resonance imaging (MRI) based redefining of the radiotherapeutic target volume will lead to a reduction of acute and late toxicity. In our center, chemoradiotherapy followed by hysterectomy was implemented successfully in the past. This enables us to assess the safety of reducing the target volume but also to explore the biological effects of chemoradiation on the resected hysterectomy specimen.MethodsThe EXIT-trial is a phase II, single arm study aimed at LACC patients. This study evaluates whether a MRI-based exclusion of the non-tumor-bearing parts of the uterus out of the target volume results in absence of tumor in the non-high doses irradiated part of the uterus in the hysterectomy specimen. Secondary endpoints include a dosimetric comparison of dose on normal tissue when comparing study treatment plans compared to treatment of the whole uterus at high doses; acute and chronic toxicity, overall survival, local relapse- and progression-free survival. In the translational part of the study, we will evaluate the hypothesis that the baseline apparent diffusion coefficient (ADC) values of diffusion weighted MRI and its evolution 2 weeks after start of CRT, for the whole tumor as well as for intra-tumoral regions, is prognostic for residual tumor on the hysterectomy specimen.DiscussionAlthough MRI is already used to guide target delineation in brachytherapy, the EXIT-trial is the first to use this information to guide target delineation in external beam radiotherapy. Early therapy resistance prediction using DW-MRI opens a window for early treatment adaptation or further dose-escalation on tumors/intratumoral regions at risk for treatment failure.Trial registrationBelgian Registration: B670201526181 (prospectively registered, 26/11/2015); ClinicalTrials.gov Identifier: NCT03542942 (retrospectively registered, 17/5/2018).

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The value of advanced MRI techniques in the assessment of cervical cancer: a review

Cited by 105 publications

References 142 publications

Imaging diagnosis and staging of pancreatic ductal adenocarcinoma: a comprehensive review

Imaging diagnosis and staging of pancreatic ductal adenocarcinoma: a comprehensive review

The necessity of radical hysterectomy (RH) for pure endometrial carcinoma combined with cervical involvement: a retrospective cohort study comparing RH with total hysterectomy (TH)

EXclusion of non-Involved uterus from the Target Volume (EXIT-trial): an individualized treatment for locally advanced cervical cancer using modern radiotherapy and imaging techniques

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