Impact of incorporating Magnetic Resonance Imaging in FIGO Staging of Primary Carcinoma Cervix: Experience from a tertiary cancer center

Abstract Objective: To determine whether there are substantive differences between the initial interpretations of magnetic resonance imaging (MRI) scans acquired at outside facilities and the second-opinion interpretations of radiologists specializing in gynecologic oncology at a tertiary cancer center, among patients referred for endometrial cancer staging. Materials and Methods: This was a retrospective, comparative analysis of 153 initial and second-opinion MRI reports for endometrial cancer staging officially submitted for review by radiologists specializing in gynecologic oncology. For each case, the relationship between the initial and second-opinion reports, regarding the suggested diagnosis and the clinically relevant MRI findings reported, was categorized as "agreement" or "disagreement". Histopathology was used in order to establish the definitive diagnosis. Results: Disagreement was found in 58 (37.9%) of the 153 cases. Second-opinion interpretations reported findings that affected the preoperative cancer staging and could have led to a change in treatment in 38 cases (24.8%); that did not affect the preoperative staging but provided information that was more accurate in 8 (5.2%); and that suggested a new cancer diagnosis in 12 (7.8%). In 37 cases (24.2%), there was a potential for changes in patient care. Among the 58 cases of disagreement, a definitive (histopathological) diagnosis was made in 41 (70.7%). In 31 (75.6%) of those 41 cases, the second-opinion report was more accurate than was the initial report. Conclusion: Discordant interpretations of MRI examinations, which can have a substantial effect on the clinical management of patients, appear to be common.

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Evaluation of the indications for performing magnetic resonance imaging of the female pelvis at a referral center for cancer, according to the American College of Radiology criteria

Radiologia Brasileira ◽

10.1590/0100-3984.2015.0123 ◽

2017 ◽

Vol 50 (1) ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

Camila Silva Boaventura ◽

Daniel Padilha Rodrigues ◽

Olimpio Antonio Cornehl Silva ◽

Fabrício Henrique Beltrani ◽

Rayssa Araruna Bezerra de Melo ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Pelvic Pain ◽

Cancer Center ◽

Resonance Imaging ◽

Female Pelvis ◽

Referral Center ◽

Acr Criteria ◽

Pelvic Malignancies ◽

Gynecologic Neoplasms

Abstract Objective: To evaluate the indications for performing magnetic resonance imaging of the female pelvis at a referral center for cancer. Materials and Methods: This was a retrospective, single-center study, conducted by reviewing medical records and imaging reports. We included 1060 female patients who underwent magnetic resonance imaging of the pelvis at a cancer center between January 2013 and June 2014. The indications for performing the examination were classified according to the American College of Radiology (ACR) criteria. Results: The mean age of the patients was 52.6 ± 14.8 years, and 49.8% were perimenopausal or postmenopausal. The majority (63.9%) had a history of cancer, which was gynecologic in 29.5% and nongynecologic in 34.4%. Of the patients evaluated, 44.0% had clinical complaints, the most common being pelvic pain (in 11.5%) and bleeding (in 9.8%), and 34.7% of patients had previously had abnormal findings on ultrasound. Most (76.7%) of the patients met the criteria for undergoing magnetic resonance imaging, according to the ACR guidelines. The main indications were evaluation of tumor recurrence after surgical resection (in 25.9%); detection and staging of gynecologic neoplasms (in 23.3%); and evaluation of pelvic pain or of a mass (in 17.1%). Conclusion: In the majority of the cases evaluated, magnetic resonance imaging was clearly indicated according to the ACR criteria. The main indication was local recurrence after surgical treatment of pelvic malignancies, which is consistent with the routine protocols at cancer centers.

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Arguments for a magnetic resonance imaging–assisted FIGO staging system for cervical cancer

International Journal of Gynecological Cancer ◽

10.1136/ijgc-00009577-200507000-00001 ◽

2005 ◽

Vol 15 (4) ◽

pp. 573-582 ◽

Cited By ~ 1

Author(s):

K. Narayan

Keyword(s):

Magnetic Resonance Imaging ◽

Cervical Cancer ◽

Magnetic Resonance ◽

Cancer Biology ◽

Surgical Techniques ◽

Staging System ◽

Combined Modality Treatment ◽

Resonance Imaging ◽

Figo Staging ◽

Patient Selection Criteria

FIGO staging of cervical cancer is based on anatomic compartmental spread of cervical cancer. This was necessary in the evaluation of surgical resectability in each patient. Even if the surgical resection was not deemed satisfactory, surgical findings and subsequent accurate anatomic pathology findings could be used to prescribe tailored adjuvant therapies. Recently, the management of cervical cancer has been influenced by the evidence from several surgical-pathologic studies and phase II and III combined modality treatment trials. However, the patient selection criteria used in these clinical studies were almost always refined by modern medical imaging and surgical techniques not prescribed in the FIGO staging system. The results obtained from these studies would not correlate with those from the patient population similarly treated but selected strictly along the FIGO staging criteria. This selective, heterogenous, and arbitrary refinement of FIGO staging has certainly given insight into cervical cancer biology but in the process has rendered the current FIGO staging of this disease quite inadequate. Prior knowledge of these factors through modern imaging in these patients could be used in staging and selecting the optimum treatment modality while minimizing the treatment-related morbidity. A magnetic resonance imaging-assisted FIGO staging system for cervical cancer as proposed here could be used for selecting patients appropriately for a given treatment package

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Current Role of Magnetic Resonance Imaging in Evaluation and Radiotherapy in Locally Advanced Carcinoma Cervix

Indian Journal of Gynecologic Oncology ◽

10.1007/s40944-016-0063-3 ◽

2016 ◽

Vol 14 (2) ◽

Author(s):

Saikat Das ◽

Santanu Samanta ◽

Manu Mathew ◽

Reetu John ◽

Abraham Peedicayil ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Locally Advanced ◽

Resonance Imaging ◽

Carcinoma Cervix ◽

Current Role ◽

Advanced Carcinoma

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Prostate Magnetic Resonance Imaging Analyses, Clinical Parameters, and Preoperative Nomograms in the Prediction of Extraprostatic Extension

Clinics and Practice ◽

10.3390/clinpract11040091 ◽

2021 ◽

Vol 11 (4) ◽

pp. 763-775

Author(s):

Natalia Majchrzak ◽

Piotr Cieśliński ◽

Maciej Głyda ◽

Katarzyna Karmelita-Katulska

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Specific Antigen ◽

Area Under The Curve ◽

Specific Site ◽

Cancer Center ◽

Clinical Parameters ◽

Resonance Imaging ◽

Cognitive Fusion ◽

Extraprostatic Extension

Introduction: Proper planning of laparoscopic radical prostatectomy (RP) in patients with prostate cancer (PCa) is crucial to achieving good oncological results with the possibility of preserving potency and continence. Aim: The aim of this study was to identify the radiological and clinical parameters that can predict the risk of extraprostatic extension (EPE) for a specific site of the prostate. Predictive models and multiparametric magnetic resonance imaging (mpMRI) data from patients qualified for RP were compared. Material and methods: The study included 61 patients who underwent laparoscopic RP. mpMRI preceded transrectal systematic and cognitive fusion biopsy. Martini, Memorial Sloan-Kettering Cancer Center (MSKCC), and Partin Tables nomograms were used to assess the risk of EPE. The area under the curve (AUC) was calculated for the models and compared. Univariate and multivariate logistic regression analyses were used to determine the combination of variables that best predicted EPE risk based on final histopathology. Results: The combination of mpMRI indicating or suspecting EPE (odds ratio (OR) = 7.49 (2.31–24.27), p < 0.001) and PSA ≥ 20 ng/mL (OR = 12.06 (1.1–132.15), p = 0.04) best predicted the risk of EPE for a specific side of the prostate. For the prediction of ipsilateral EPE risk, the AUC for Martini’s nomogram vs. mpMRI was 0.73 (p < 0.001) vs. 0.63 (p = 0.005), respectively (p = 0.131). The assessment of a non-specific site of EPE by MSKCC vs. Partin Tables showed AUC values of 0.71 (p = 0.007) vs. 0.63 (p = 0.074), respectively (p = 0.211). Conclusions: The combined use of mpMRI, the results of the systematic and targeted biopsy, and prostate-specific antigen baseline can effectively predict ipsilateral EPE (pT3 stage).

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