Magnetic Resonance Imaging of the Cervix, and its Relevance to the Revised International Federation of Gynecology and Obstetrics (FIGO) Staging

2012 ◽  
Vol 8 (2) ◽  
pp. 100-106
Author(s):  
Penelope Moyle ◽  
Evis Sala
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
International Federation ◽  
Resonance Imaging ◽  
Figo Staging ◽  
Gynecology And Obstetrics

Diagnostic significance of magnetic resonance imaging in patients with cervical cancer after brachytherapy: a meta-analysis

2018 ◽  
Vol 60 (5) ◽  
pp. 670-676
Author(s):  
Ji Zhang ◽  
Weizhong Tian ◽  
Xinhua Bu ◽  
Xiulan Wang ◽  
Fangzheng Tian ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cervical Cancer ◽  
Magnetic Resonance ◽  
Predictive Value ◽  
Residual Tumor ◽  
Uterine Cervical Cancer ◽  
Cochrane Library ◽  
Resonance Imaging ◽  
Diagnostic Significance ◽  
Gynecology And Obstetrics

Background Patients with uterine cervical cancer suffer high mortality. Accurate detection of a residual tumor by magnetic resonance imaging (MRI) during and after directed brachytherapy (BCT) is crucial for the success of cancer treatment and is a significant predictor of patient survival. Purpose To determine the diagnostic significance of MRI in detecting residual tumor tissue after BCT. Material and Methods The Web of Knowledge, Cochrane Library, and PubMed were systematically searched (January 1997 to December 2016) for post-brachytherapy MRI studies that measured residual tumors in patients with uterine cervical cancer. All data were analyzed using the Meta-Disc 1.4 program. Results Four clinical studies consisting of 163 patients (147 of whom were included in the present analysis) who were diagnosed with uterine cervical cancer according to the International Federation of Gynecology and Obstetrics (FIGO) staging system were included in the study. All the patients received BCT and underwent MRI detection of residual tumors tissue. In studies where the accuracy of MRI detection was confirmed by histological tests or gynecological tests, the summary estimates of specificity, sensitivity, positive predictive value, negative predictive value, and accuracy were 88.5%, 83.5%, 53.5%, 97.1%, and 84.3%, respectively. Conclusion MRI-directed BCT is commonly used for cervical cancer patients. Based on our investigation of four independent studies, MRI showed better prediction of positive results than negative results in patients with cervical cancer after BCT. However, more data on the greater numbers of patients are needed to establish the accuracy of MRI detection of cervical cancer after BCT.

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

2005 ◽  
Vol 15 (4) ◽  
pp. 573-582 ◽  
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

Evaluation of carcinoma cervix using magnetic resonance imaging: Correlation with clinical FIGO staging and impact on management

2012 ◽  
Vol 56 (1) ◽  
pp. 58-65 ◽  
Author(s):  
Nilu Malpani Dhoot ◽  
Vinay Kumar ◽  
Atul Shinagare ◽  
Amal Chandra Kataki ◽  
Debabrata Barmon ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Resonance Imaging ◽  
Carcinoma Cervix ◽  
Figo Staging

Assessment of the Early Predictive Power of Quantitative Magnetic Resonance Imaging Parameters During Neoadjuvant Chemotherapy for Uterine Cervical Cancer

2014 ◽  
Vol 24 (4) ◽  
pp. 751-757 ◽  
Author(s):  
Yuki Himoto ◽  
Koji Fujimoto ◽  
Aki Kido ◽  
Noriomi Matsumura ◽  
Tsukasa Baba ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cervical Cancer ◽  
Magnetic Resonance ◽  
Neoadjuvant Chemotherapy ◽  
Tumor Volume ◽  
Pearson Correlation ◽  
Contrast Material ◽  
Resonance Imaging ◽  
Gynecology And Obstetrics ◽  
Diffusion Parameters

ObjectivesThe purpose of this study was to quantitatively evaluate 3 types of magnetic resonance imaging (MRI) parameters in parallel for the early prediction of neoadjuvant chemotherapy (NACT) effectiveness in cervical cancer—tumor volume parameters, diffusion parameters, and perfusion parameters.Materials and MethodsWe prospectively evaluated 13 patients with International Federation of Gynecology and Obstetrics stage IB to IIB cervical squamous cell carcinoma who underwent 3 serial MRI studies, that is, pretreatment, post–first course NACT, and post–second course NACT followed by radical hysterectomy. We obtained tumor volume parameters, diffusion parameters, and dynamic contrast material–enhanced perfusion parameters quantitatively from pretreatment MRI and post–first course MRI. The correlation of these parameters and the eventual tumor volume regression rate (TVRR) obtained from pretreatment MRI and post–second course MRI before surgery were investigated, statistically based on the Pearson correlation coefficient.ResultsThirteen patients had a total of 39 scans. Early TVRR (r= 0.844;P< 0.001), the fractional volume of the tissue extracellular extravascular space (Ve,r= 0.648;P< 0.05), and the change of Ve during the first course of NACT (r= −0.638;P< 0.05) correlated with eventual TVRR.ConclusionsEarly TVRR, Ve, and the change of Ve could be useful predictors for the treatment effectiveness of NACT. These parameters could help to modify strategy in the early stage of NACT and to choose individualized treatment to avoid the delay of radical treatment, even when NACT is ineffective.

scholarly journals Pretreatment Mean Apparent Diffusion Coefficient Is Significantly Correlated With Event-Free Survival in Patients With International Federation of Gynecology and Obstetrics Stage Ib to IIIb Cervical Cancer

2015 ◽  
Vol 25 (6) ◽  
pp. 1079-1085 ◽  
Author(s):  
Yuki Himoto ◽  
Koji Fujimoto ◽  
Aki Kido ◽  
Tsukasa Baba ◽  
Shiro Tanaka ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cervical Cancer ◽  
Diffusion Coefficient ◽  
International Federation ◽  
Resonance Imaging ◽  
Event Free Survival ◽  
Free Survival ◽  
Stage Ib ◽  
Gynecology And Obstetrics ◽  
Apparent Diffusion

ObjectivesTo assess the prognostic impact of the pretreatment mean apparent diffusion coefficient (ADCmean) values of tumors obtained by diffusion-weighted magnetic resonance imaging. We evaluated the prognostic value of the ADCmean for event-free survival (EFS) and overall survival (OS) among patients with uterine cervical cancer.Methods/MaterialsWe included 171 patients diagnosed as having International Federation of Gynecology and Obstetrics stage Ib to IIIb cervical cancer by pretreatment magnetic resonance imaging scans, regardless of therapeutic methods. In all patients and in patients with squamous cell carcinoma (SCC; n = 123), the optimal cutoff values of the tumor ADCmean for EFS and for OS were determined, respectively. The prognostic significance of the ADCmean was evaluated using univariate and multivariate Cox regression analyses.ResultsIn the univariate analyses, the ADCmean values were significantly associated with negative effects on EFS both in all patients and in patients with SCC, while not being significantly associated with OS in both groups. In the multivariate analysis, ADCmean was an independent biomarker for EFS (P < 0.05) in patients with SCC along with lymph node metastasis and definitive surgery, whereas ADCmean was not independently significant in EFS in all patients.ConclusionsThe pretreatment ADCmean value of the tumor was an independent prognostic factor for EFS in International Federation of Gynecology and Obstetrics stage Ib to III SCC of the uterine cervix.

scholarly journals Accuracy of Ultrasonography and Magnetic Resonance Imaging for Preoperative Staging of Cervical Cancer—Analysis of Patients from the Prospective Study on Total Mesometrial Resection

Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1749
Author(s):  
Maciej Stukan ◽  
Paul Buderath ◽  
Bartosz Szulczyński ◽  
Jacek Gębicki ◽  
Rainer Kimmig
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cervical Cancer ◽  
Magnetic Resonance ◽  
Measurement Errors ◽  
Tumor Staging ◽  
Preoperative Staging ◽  
Resonance Imaging ◽  
Uterine Corpus ◽  
Gynecology And Obstetrics ◽  
Imaging Results

We aimed to evaluate the accuracy of ultrasonography with gynecologic examination performed by a gynecological oncologist and magnetic resonance imaging (MRI) interpreted by a radiologist for the local and regional staging of patients with early-stage cervical cancer. The study was a single-site sub-analysis of the multi-institutional prospective, observational Total Mesometrial Resection (TMMR) Register Study, which included all consecutive study patients from Gdynia Oncology Center. Imaging results were compared with pathology findings. A total of 58 consecutive patients were enrolled, and 50 underwent both ultrasonography and MRI. The accuracy of tumor detection and measurement errors was comparable across ultrasonography and MRI. There were no significant differences between ultrasonography and MRI in the accuracy of detecting parametrial involvement (92%, confidence interval (CI) 84–100% vs. 76%, CI 64–88%, p = 0.3), uterine corpus infiltration (94%, CI 87–100% vs. 86%, CI 76–96%, p = 0.3), and vaginal fornix involvement (96%, CI 91–100% vs. 76%, CI 64–88%, p = 0.3). The importance of uterine corpus involvement for the first-line lymph node metastases was presented in few cases. The accuracy of ultrasonography was higher than MRI for correctly predicting tumor stage: International Federation of Gynecology and Obstetrics (FIGO)–2018: 69%, CI 57–81% vs. 42%, CI 28–56%, p = 0.002, T (from TNM system): 79%, CI 69–90% vs. 52%, CI 38–66%, p = 0.0005, and ontogenetic tumor staging: 88%, CI 80–96% vs. 70%, CI 57–83%, p = 0.005. For patients with cervical cancer who are eligible for TMMR and therapeutic lymphadenectomy, the accuracy of ultrasonography performed by gynecological oncologists is not inferior to that of MRI interpreted by a radiologist for assessing specific local parameters, and is more accurate for local staging of the disease and is thus more clinically useful for planning adequate surgical treatment.

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