Preoperative imaging in patients undergoing trachelectomy for cervical cancer: Validation of a combined T2- and diffusion-weighted endovaginal MRI technique at 3.0T
| Autor: | Veronica A. Morgan, Sharon L. Giles, John H. Shepherd, Nandita M. deSouza, Ayoma D. Attygalle, Katherine Downey, Steve Hazell, Thomas Ind |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment Trachelectomy Uterine Cervical Neoplasms Cervix Uteri Hysterectomy Sensitivity and Specificity Preoperative care Article Cohort Studies Positive predicative value Preoperative Care Obstetrics and Gynaecology Carcinoma Humans Medicine Cervical canal Cervical cancer medicine.diagnostic_test business.industry Fertility-sparing Volume Endovaginal Fertility Preservation Obstetrics and Gynecology Magnetic resonance imaging medicine.disease Magnetic Resonance Imaging Tumor Burden Diffusion Magnetic Resonance Imaging medicine.anatomical_structure Oncology Female Radiology business Organ Sparing Treatments MRI |
| Zdroj: | Gynecologic Oncology |
| ISSN: | 0090-8258 |
| DOI: | 10.1016/j.ygyno.2014.02.026 |
| Popis: | Aim The aim of this study is to validate high-resolution endovaginal T2- and diffusion-weighted MRI measurements (tumour size, volume and length of uninvolved cervical canal) against histology in patients undergoing trachelectomy. Patients/interventions 55 consecutive patients 25–44 years with cervical cancer being considered for trachelectomy were prospectively assessed with endovaginal T2-W and diffusion-weighted MRI. Two independent observers blinded to histology recorded maximum tumour dimension, volume and distance from the superior aspect of the tumour to the internal os. Following trachelectomy, pathologist-outlined tumour sections were photographed with a set scale and similar measurements were recorded. Results Fifteen of 45 patients subsequently treated with fertility-sparing surgery had residual tumour (median histological volume: 0.28 cm3, IQR = 0.14–1.06 cm3). Sensitivity, specificity, positive and negative predictive values for detecting tumour: Observer1: 86.7%, 80.0%, 68.4%, and 92.3%, respectively; Observer2: 86.7%, 90.0%, 81.0%, and 93.1%, respectively. Size and volume correlated between observers (r = 0.96, 0.84, respectively, p Highlights • High spatial resolution endovaginal MRI of the cervix in patients potentially selected for trachelectomy • Correlation of MRI with histopathology in subcentimetre cervical tumours • Interobserver comparison of measured tumour maximum dimension and volume on endovaginal MRI |
| Databáze: | OpenAIRE |
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