The value of 3.0 Tesla diffusion-weighted MRI for pelvic nodal staging in patients with early stage cervical cancer
Autor: | Petra H.M. Peeters, Daisy M.D.S. Sie-Go, A.P.M. Heintz, Henk W.R. Schreuder, Wenche M. Klerkx, M. A. A. J. van den Bosch, J. van der Velden, Anje M. Spijkerboer, Jaap Stoker, Willem P.Th.M. Mali, Shandra Bipat, Wouter B. Veldhuis |
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Přispěvatelé: | ACS - Amsterdam Cardiovascular Sciences, Other Research, Radiology and Nuclear Medicine, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, CCA -Cancer Center Amsterdam, Obstetrics and Gynaecology |
Jazyk: | angličtina |
Rok vydání: | 2012 |
Předmět: |
Adult
Cancer Research medicine.medical_specialty Uterine Cervical Neoplasms DWI Adenocarcinoma Sensitivity and Specificity Human Movement & Fatigue Quality of Care [NCEBP 10] Diagnostic accuracy Pelvis Carcinoma Adenosquamous Young Adult Confidence Intervals medicine Humans Effective diffusion coefficient Prospective Studies Stage (cooking) Aged Neoplasm Staging Observer Variation Cervical cancer Lymph node metastasis Reproducibility medicine.diagnostic_test business.industry Area under the curve Reproducibility of Results Magnetic resonance imaging Middle Aged medicine.disease Confidence interval Diffusion Magnetic Resonance Imaging ROC Curve Oncology Cervix cancinoma Lymphatic Metastasis Carcinoma Squamous Cell Specificity Lymph Node Excision Female Radiology business Adenocarcinoma Clear Cell Diffusion MRI |
Zdroj: | European journal of cancer (Oxford, England, 48(18), 3414-3421. Elsevier Limited European Journal of Cancer, 48, 3414-21 European Journal of Cancer, 48, 18, pp. 3414-21 |
ISSN: | 0959-8049 |
Popis: | Contains fulltext : 109962.pdf (Publisher’s version ) (Open Access) OBJECTIVE: The purpose of this study is to investigate the diagnostic accuracy of 3.0Tesla (3T) diffusion-weighted magnetic resonance imaging (MRI) in addition to conventional MRI for the detection of lymphadenopathy in patients with early stage cervical cancer compared to histopathological evaluation of the systematically removed pelvic lymph nodes as reference standard. METHODS: 68 federation internationale de gynecologie obstetrique (FIGO) stage Ia2 to IIb cervical cancer patients were included. Sensitivity and specificity rates for two experienced observers were computed for the detection of lymphatic metastasis. Reproducibility of conventional MRI was tested by kappa statistics. The variables included in the analysis were: size of the long axis, short axis, ratio short to long axis and apparent diffusion coefficient (ADC). RESULTS: Nine patients had 15 positive pelvic nodes at histopathological examination. The sensitivity and specificity of lymphatic metastasis detection by predefined conventional MRI characteristics was 33% (95% Confidence Interval (CI) 3-64) and 83% (95% CI 74-93) on patient level, and 33% (95% CI 7-60) and 97% (95% CI 95-99) on regional level respectively for observer 1. For observer 2 the sensitivity was 33% (95% CI 3-64) and the specificity 93% (95% CI 87-100) on patient level, and 25% (95% CI 1-50) and 98% (95% CI 97-100) on regional level, respectively. The kappa-value for reproducibility of metastasis detection on regional level was 0.50. The short axis diameter showed the highest diagnostic accuracy (area under the curve (AUC)=0.81 95% CI 0.70-0.91); ADC did not improve diagnostic accuracy (AUC=0.83 95% CI 0.73-0.93). CONCLUSIONS: Diffusion-weighted MRI did not result in additional diagnostic value compared to conventional MRI. |
Databáze: | OpenAIRE |
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