Diffusion-weighted magnetic resonance imaging of primary cervical cancer in the detection of sub-centimetre metastatic lymph nodes

Autor: Keith Wan-Hang Chiu, Ka Yu Tse, Elaine Yuen Phin Lee, Lawrence W. C. Chan, Jose Angelo Udal Perucho, Pek-Lan Khong, Herbert Pang, Mandy M.Y. Chu, Esther Man Fung Wong
Jazyk: angličtina
Rok vydání: 2020
Předmět:
lcsh:Medical physics. Medical radiology. Nuclear medicine
Adult
Male
endocrine system
lcsh:R895-920
Uterine Cervical Neoplasms
Cervical Cancer
lcsh:RC254-282
Metastasis
Magnetic resonance imaging
medicine
Effective diffusion coefficient
Humans
Radiology
Nuclear Medicine and imaging
Lymph node
Intravoxel incoherent motion
Aged
Cervical cancer
Observer Variation
Lymph node metastasis
Radiological and Ultrasound Technology
medicine.diagnostic_test
business.industry
General Medicine
Middle Aged
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
medicine.disease
Perfusion
medicine.anatomical_structure
Diffusion Magnetic Resonance Imaging
Oncology
Positron emission tomography
Lymphatic Metastasis
Female
Diffusion-weighted imaging
business
Nuclear medicine
Diffusion MRI
Research Article
Zdroj: Cancer Imaging
Cancer Imaging, Vol 20, Iss 1, Pp 1-9 (2020)
ISSN: 1470-7330
1740-5025
Popis: Background Magnetic resonance imaging (MRI) has limited accuracy in detecting pelvic lymph node (PLN) metastasis. This study aimed to examine the use of intravoxel incoherent motion (IVIM) in classifying pelvic lymph node (PLN) involvement in cervical cancer patients. Methods Fifty cervical cancer patients with pre-treatment magnetic resonance imaging (MRI) were examined for PLN involvement by one subspecialist and one non-subspecialist radiologist. PLN status was confirmed by positron emission tomography or histology. The tumours were then segmented by both radiologists. Kruskal-Wallis tests were used to test for differences between diffusion tumour volume (DTV), apparent diffusion coefficient (ADC), pure diffusion coefficient (D), and perfusion fraction (f) in patients with no malignant PLN involvement, those with sub-centimetre and size-significant PLN metastases. These parameters were then considered as classifiers for PLN involvement, and were compared with the accuracies of radiologists. Results Twenty-one patients had PLN involvement of which 10 had sub-centimetre metastatic PLNs. DTV increased (p = 0.013) while ADC (p = 0.015), and f (p = 0.006) decreased as the nodal status progressed from no malignant involvement to sub-centimetre and then size-significant PLN metastases. In determining PLN involvement, a classification model (DTV + f) had similar accuracies (80%) as the non-subspecialist (76%; p = 0.73) and subspecialist (90%; p = 0.31). However, in identifying patients with sub-centimetre PLN metastasis, the model had higher accuracy (90%) than the non-subspecialist (30%; p = 0.01) but had similar accuracy with the subspecialist (90%, p = 1.00). Interobserver variability in tumour delineation did not significantly affect the performance of the classification model. Conclusion IVIM is useful in determining PLN involvement but the added value decreases with reader experience.
Databáze: OpenAIRE
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