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
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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