Preoperative imaging in patients undergoing trachelectomy for cervical cancer: validation of a combined T2- and diffusion-weighted endovaginal MRI technique at 3.0 T.
Gynecol Oncol
; 133(2): 326-32, 2014 May.
Article
em En
| MEDLINE
| ID: mdl-24582988
ABSTRACT
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 cm(3), IQR=0.14-1.06 cm(3)). Sensitivity, specificity, positive and negative predictive values for detecting tumour Observer 1 86.7%, 80.0%, 68.4%, and 92.3%, respectively; Observer 2 86.7%, 90.0%, 81.0%, and 93.1%, respectively. Size and volume correlated between observers (r=0.96, 0.84, respectively, p<0.0001). Size correlated between each observer and histology (observer 1 r=0.91, p<0.0001; observer 2 r=0.93, p<0.0001), volume did not (observer 1 r=0.08, p=0.6; observer 2 r=0.21, p=0.16); however, differences between observer measurements and histology were not significant (size p=0.09, volume p=0.15). Differences between MRI and histology estimates of endocervical canal length were not significant (p=0.1 both observers).CONCLUSION:
In subcentimetre cervical cancers, endovaginal MRI correlates with pathology and is invaluable in assessing patients for fertility-sparing surgery.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Imageamento por Ressonância Magnética
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Carcinoma
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Neoplasias do Colo do Útero
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Colo do Útero
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Histerectomia
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Female
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Humans
Idioma:
En
Ano de publicação:
2014
Tipo de documento:
Article