MRI OPPORTUNITIES IN CERVICAL CANCER LOCAL STAGING PREOPERATIVE EVALUATION
Abstract
Objective: The purpose of this study is to elucidate the opportunities of magnetic resonance imaging (MRI) for local staging perioperative evaluation in patients with cervical cancer.Materials and methods: 253 253 patients with cervical cancer were included in study. All patients underwent examination and treatment in the Herzen Moscow Research Cancer Institute. Average age of patients was 35 + 5.6 years (21-67 years). Patients were divided int two groups: I-group included 114 woman, in which patients underwent surgical treatment and 56 patients on chemoradiation therapy, that preceded the surgery; II-group included 83 patients, in which the first stage of treatment was neoadjuvant therapy. MRI was performed in all patients within one week before radical surgery. MRI results have been compared with the histopathological report of the hysterectomy specimen. Results: The accuracy, sensitivity and specificity of MRI for perioperative evaluationof cervical cancer local staging in I group were 87%, 67%, 81%, positive predictive values (PPVs) and negative predictive values (NPVs) were 94% and 56%, respectively. For II group accuracy, sensitivity and specificity of MRI were 72%, 90%, 83%, PPVs and NPVs were 83%. Conclusion: MRI has a high diagnostic performance in preoperative staging of cervical cancer, content regardless of neoadjuvantt herapy. MRI allows to optimize the individual treatment plan in patients with cervical cancer.
About the Authors
N. A. Rubtsova
Federal State Department «Hertzen Moscow Research Cancer Institute» Ministry of Health and Social Development of the Russian Federation, Moscow
Russian Federation
Russian Federation
E. G. Novikova
Federal State Department «Hertzen Moscow Research Cancer Institute» Ministry of Health and Social Development of the Russian Federation, Moscow
Russian Federation
Russian Federation
V. E. Sinitsyn
Federal State Department «Center of Medicine and Rehabilitation» Ministry of Health and Social Development of the Russian Federation, Moscow
Russian Federation
Russian Federation
References
1. Кудреватых Е.В. Магнитно-резонансная томография в диагностике и оценке результатов комплексного лечения рака шейки матки. Автореф. дисс. канд. мед. наук. М. 2011; 24 с.
2. Руководство по онкологии. Под ред. В.И. Чиссова, С.Л. Дарьяловой. М.: МИА. 2008; 835 с.
3. Чиссов В.И., Старинский В.В. с соавт. Состояние онкологической помощи населению Российской Федерацию. М.: РИИС ФИАН. 2010; 18 с.
4. American Joint Committee on Cancer. In: Greene F.L., Balch C.M., Page D.L. et al. Cancer Staging Manual, 6th end. Chicago: Springer. 2002; 301 p.
5. Bipat S., Glas A.S., Van der Velden, Zwinderman A.H. Computed tomography and magnetic resonance imaging in staging of uterine cervical carcinoma: a systematic review. Gynecol. Oncol. 2003; 86 (5): 31-7.
6. Boss E.A., Barentsz J.O., Massuger L.F., Boonstra H. The role of MR imaging in invasive cervical carcinoma. Eur. Radiol. 2000; 10 (2): 256-70.
7. Choi S.H., Kim S.H., Choi H.J., Park B.K. Preoperative magnetic resonance imaging staging of uterine cervical carcinoma: results of prospective study. Journal of comput. assist tomography. 2004; 28 (5): 620-7.
8. De Souza N.M., Dina R., McIndoe G.A., Soutter W.P. Cervical cancer: value of an endovaginal coil magnetic resonance imaging technique in detecting small volume disease and assessing parametrial extension. GynecolOncol. 2006; 102 (1): 80-5.
9. Greco A., Mason P., Leung A.W.L., Dische S. et al. Staging of carcinoma of the uterine cervix: MRI surgical correlation. Clin. Radiol. 1989; 40: 401-405.
10. Hancke K., Heilmann V., Straka P., Kreienberg R. et al. Pretreatment staging of cervical cancer: is imaging better than palpation?: Role of CT and MRI in preoperative staging of cervical cancer: single institution results for 255 patients. Ann. Surg. Oncol. 2008; 15 (10): 2856-61.
11. Hori M., Kim T., Murakami T. et al. Uterine Cervical Carcinoma: Preoperative Staging with 3.0-T MR Imaging-Comparison with 1.5-T MR Imaging. Radiology. 2009; 251 (1): 96-104.
12. Hricak H. MRI of the female pelvis: a review. AJR. 2006; 146: 1115-1122.
13. Hricak H., Oguz A., Sala E. et al. Diagnostic imaging gynecology. Copyright -Amirsys. 2007; 1-22.
14. Hricak H., Gatsonis C., Coakley F.V. et al. Early Invasive Cervical Cancer: CT and MR Imaging in Preoperative Evaluation-ACRIN/GOG Comparative Study of Diagnostic Performance and Interobserver Variability. Radiology. 2007; 245 (2): 91-8.
15. Hulse P., Carrington B. MRI manual of pelvic cancer.Martin Dunitz Taylor & Francis group. London and New York, 2004. 256 p.
16. Li X.C., Shang J.B., Wu X.M., Zeng Q.S. MRI findings of uterine cervical cancer and value of MRI in preoperative staging. Nan Fang Yi Ke Da Xue Xue Bao. 2007; 27 (3): 352-4.
17. Ozsarlak O., Tjalma W., Schepens E., Corthouts B. et al. The correlation of preoperative CT, MR imaging, and clinical staging (FIGO) with histopathology findings in primary cervical carcinoma. Eur. Radiol. 2003; 13 (10): 2338-45.
18. Pandharipande Pari. V., Choy G., Del Carmen M.G. et al. MRI and PET/CT for Triaging Stage IB Clinically Operable Cervical Cancer to Appropriate Therapy: Decision Analysis to Assess Patient Outcomes. American Journal of Radiology. 2009; 192: 802-814.
19. Sahdev A., Sohaib S.A., Wenaden A.E., Shepherd J.H. et al. The performance of magnetic resonance imaging in early cervical carcinoma: a long-term experience. Int. J. Gynecol. Cancer. 2007; 17 (3): 629-36.
20. Savelli L., Ceccarini M., Ludovisi M., Fruscella E. et al. Preoperative local staging of cervical cancer: transvaginalsonography vs. magnetic resonance imaging. Ultrasound Obstet Gynecol. 2008; 31 (5): 560-6.
21. Sethi T.K., Bhalla N.K., Jena A.N., Rawat S. et al. Magnetic resonance imaging in carcinoma cervix-does it have a prognostic relevance. J. Cancer Res. Ther. 2005; 2: 103-7.
22. Zand K.R., Reinhold C., Abe H., Maheshwari S. et al. Magnetic resonance imaging of the cervix. Cancer Imaging. 2007; 28 (7): 69-76.
For citation:
Rubtsova N.A., Novikova E.G., Sinitsyn V.E. MRI OPPORTUNITIES IN CERVICAL CANCER LOCAL STAGING PREOPERATIVE EVALUATION. Obstetrics, Gynecology and Reproduction. 2012;6(3):6-13. (In Russ.)
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