Preoperative evaluation of uterine isthmus-cervical infiltration in patient with cervical cancer using nuclear magnetic resonance

2013 ◽  
Vol 21 (3-4) ◽  
pp. 87-90
Author(s):  
Aljosa Mandic ◽  
Tamara Vujkov ◽  
Natasa Prvulovic ◽  
Bojana Gutic ◽  
Slavica Knezevic-Usaj
Keyword(s):  
Cervical Cancer ◽  
Magnetic Resonance ◽  
Positive Predictive Value ◽  
Fertility Preservation ◽  
Predictive Value ◽  
Histopathological Examination ◽  
Young Patients ◽  
Figo Stage ◽  
Uterine Corpus ◽  
Fertility Sparing

Background: During the last three decades, fertility preservation has been established as a new treatment modality for young patients with early cervical cancer. In preservation of the uterine corpus in fertility sparing surgery one of the most important factors is evaluation of absence of internal uterine ostium or uterine corpus tumor infiltration. The aim was to evaluate the accuracy of nucler magnetic resonance (NMR) in detection of infiltration of uterine isthmuscervical part in cervical cancer patients without fertility preservation. Methods: In 60 patients with cervical cancer FIGO stage IA-2 - IVA, NMR was performed before the operation. Radical hysterectomy Piver class III was performed in 57 patients and pelvic exenteration in three patients with FIGO stage IVA. The histopathological material was examed at the Department of pathology and cytology and it was used as a gold standard. Results: The patient average age was 44.7, (range: 25-65 years). Squamous cervical cancer was diagnosed in 53 (88.3%), adenocarcinoma in 4 (6.7%), and adenosquamous carcinoma in 3 (5%) patients. According to NMR findings, 7 (11.7%) patients were with uterine isthmus-cervical infiltration when compared with histopathological examination, which established infiltration in 10 (16.7%) patients. Sensitivity of NMR was 60%, specificity 98%, positive predictive value 85.7%, and negative predictive value was 92.5% with overall accuracy 91.7%. Conclusion: Sensitivity of NMR was low compared with other studies but with high specificity and overall accuracy. The positive predictive value was relatively acceptable. Negative findings of NMR for corporal infiltration and precise evaluation of the depth of stromal infiltration and length of the proximal cervix without infiltration are important in preoperative diagnostic for fertility preservation surgery.

Fertility Preservation in Young Women With Cervical Cancer: An Oncologic Dilemma or a New Conception of Fertility Sparing Surgery?

2013 ◽  
Vol 31 (3) ◽  
pp. 189-189 ◽  
Author(s):  
Salvatore Gizzo ◽  
Emanuele Ancona ◽  
Tito Silvio Patrelli ◽  
Carlo Saccardi ◽  
Omar Anis ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Fertility Preservation ◽  
Young Women ◽  
Fertility Sparing Surgery ◽  
Fertility Sparing

scholarly journals Surgical and pathologic outcomes of fertility-sparing radical abdominal trachelectomy for FIGO stage IB1 cervical cancer

2008 ◽  
Vol 111 (2) ◽  
pp. 261-264 ◽  
Author(s):  
Nadeem R. Abu-Rustum ◽  
Nikki Neubauer ◽  
Yukio Sonoda ◽  
Kay J. Park ◽  
Mary Gemignani ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Figo Stage ◽  
Fertility Sparing

scholarly journals Correlation of clinical examination, ultrasound, magnetic resonance imaging and arthroscopy as diagnostic tools in shoulder pathology

2020 ◽  
Vol 6 (2) ◽  
pp. 247
Author(s):  
Sondipon Biswas ◽  
Naman Kanodia ◽  
Rajat Tak ◽  
Siddharth Agrawal ◽  
Kiran Shankar Roy
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Rotator Cuff ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Gold Standard ◽  
Shoulder Arthroscopy ◽  
Resonance Imaging ◽  
Shoulder Pathologies

<p class="abstract"><strong>Background:</strong> Shoulder pathologies can cause significant pain, discomfort, and affect the activity of daily living. The aim of this study was to compare the efficacy of clinical examination, ultrasound, magnetic resonance imaging (MRI) with shoulder arthroscopy in diagnosing various shoulder pathologies, considering shoulder arthroscopy as the gold standard tool.</p><p class="abstract"><strong>Methods:</strong> This was a prospective, comparative study conducted over 35 patients, between 18-75 years of age presenting with chronic shoulder pain or instability of more than 2 months duration. All patients were examined clinically, followed by high resolution ultrasound, MRI, arthroscopy of the affected shoulder.<strong></strong></p><p class="abstract"><strong>Results:</strong> The sensitivity and specificity of ultrasonography (USG) for diagnosing full thickness tear was 100% each and for MRI was 88% and 100% respectively. For subacromial impingement USG had sensitivity of 66.67%, specificity of 94.12%, positive predictive value of 50% and negative predictive value of 88.89%. For rotator cuff tear USG had sensitivity of 92.86%, specificity of 50%, positive predictive value of 81.25% and negative predictive value of 75% considering shoulder arthroscopy as gold standard.</p><p class="abstract"><strong>Conclusions:</strong> USG and MRI both are sensitive techniques for diagnosing of rotator cuff pathologies. USG has high accuracy in diagnosing partial thickness tears as compare to MRI. MRI proved to be superior in estimation of site and extent of tear. Considering shoulder arthroscopy as gold standard, it can be reserved for patients with suspicious of USG/MRI findings or those who may need surgical intervention simultaneously.</p>

scholarly journals Fertility sparing surgery following neoadjuvant chemotherapy of cervical cancer figo stage IB2 - case report

2019 ◽  
Author(s):  
Aljosa Mandic ◽  
Miona Davidovic-Grigoraki ◽  
Bojana Gutic ◽  
Natasa Prvulovic Bunovic ◽  
Nenad Solajic ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Case Report ◽  
Neoadjuvant Chemotherapy ◽  
Figo Stage ◽  
Fertility Sparing Surgery ◽  
Fertility Sparing

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.

scholarly journals Use of a Sentinel Lymph Node Biopsy Algorithm in a South African Population of Patients With Cervical Cancer and High Prevalence of Human Immunodeficiency Virus Infection

2018 ◽  
Vol 28 (7) ◽  
pp. 1432-1437 ◽  
Author(s):  
Leon Cornelius Snyman ◽  
Emma P. Bryant ◽  
Elize I. Wethmar ◽  
Tom de Greve ◽  
Florette Reyneke ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Immunodeficiency Virus ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Detection Rate ◽  
Immunodeficiency Virus ◽  
High Prevalence ◽  
Sensitivity Specificity

ObjectivesCervical cancer is common in resource-poor settings with high prevalence of tuberculosis, pelvic inflammatory disease, and human immunodeficiency virus (HIV) infection. There are no data regarding the sentinel lymph node (SLN) algorithm in these high-risk cancer populations. Our objectives were to establish the sensitivity, specificity, positive predictive value, and negative predictive value of the SLN algorithm in cervical cancer and to compare the detection rate of indocyanine green (ICG) versus blue dye versus technetium Tc 99m nanocolloid (99mTc).MethodsThis prospective study was conducted at the University of Pretoria. 99mTc-nanocolloid tracer, ICG dye, and methylene blue (MB) were used to detect SLNs. Pathological ultrastaging was performed on hematoxylin-eosin– negative nodes.ResultsResults of 72 women were analyzed. The mean age was 47.2 years, 5.5% had a history of tuberculosis, 18.1% had pelvic inflammatory disease, and 65.3% were HIV positive. The SLN detection rate was 65.3%. Detection rate of MB was 56.9%; 99mTc, 69.4%; ICG, 87.5%; and the combination of MB and 99mTc, 91.7%. Pelvic nodal metastases occurred in 26.4%. The sensitivity, specificity, negative predictive value, and positive predictive value of SLN biopsy were 85.7%, 100%, 100%, and 98.33%, respectively. The false-negative rate was 14.3%, and it was 0% if the algorithm was applied.ConclusionsThe SLN algorithm is a feasible option for use in cervical cancer women with a high prevalence of HIV infection. The detection rate is generally lower, but in select subgroups of women, it was comparable to that reported elsewhere. This is the first report of the use of SLN biopsy in a substantial group of HIV-infected women.

The Crank Test, the O'Brien Test, and Routine Magnetic Resonance Imaging Scans in the Diagnosis of Labral Tears

2002 ◽  
Vol 30 (6) ◽  
pp. 806-809 ◽  
Author(s):  
William B. Stetson ◽  
Kevin Templin
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Shoulder Arthroscopy ◽  
Rotator Cuff Tears ◽  
Resonance Imaging ◽  
Routine Magnetic Resonance Imaging ◽  
Labral Tears

Background Tears of the superior labrum of the shoulder, anterior to posterior, are difficult to diagnose clinically. Purpose We examined whether the crank or O'Brien tests were reliable tools for detecting glenoid labral tears. Study Design Nonrandomized prospective study. Methods Results of diagnostic shoulder arthroscopy were compared with those of the preoperative tests and magnetic resonance imaging for 65 patients who had symptoms of shoulder pain. Results The crank test result was positive in 29 patients (45%), and the O'Brien test was positive in 41 patients (63%). The crank test had a positive predictive value of 41%, was 56% specific, 46% sensitive, and had a negative predictive value of 61%. The O'Brien test had a positive predictive value of 34%, was 31% specific, 54% sensitive, and had a negative predictive value of 50%. Magnetic resonance imaging had a positive predictive value of 63%, was 92% specific, 42% sensitive, and had a negative predictive value of 83%. Conclusions The O'Brien and crank tests were not sensitive clinical indicators for detecting glenoid labral tears and other tears of the anterior and posterior labrum. Results were often falsely positive for patients with other shoulder conditions, including impingement or rotator cuff tears.

Identification of ideal strategy of cervical cancer screening in Japan based on Fukui cervical cancer screening study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e17025-e17025
Author(s):  
Tetsuji Kurokawa ◽  
Akiko Shinagawa ◽  
Yoko Chino ◽  
Motohiro Kobayashi ◽  
Yoshio Yoshida
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Positive Predictive Value ◽  
Cervical Cancer Screening ◽  
Predictive Value ◽  
Screening Method ◽  
Hpv Testing ◽  
Abnormal Cytology ◽  
Predictive Values ◽  
Hpv Status

e17025 Background:The estimated age-standardized incidence rate for cervical cancer is higher in Japan than in North America and the UK. It is important to improve cancer screening. The introduction of HPV testing with cytology for triage of those that test positive for cervical cancer screening has been challenging. The Fukui Cervical Cancer Screening (FCCS) study was designed to determine the best cervical cancer screening method in the Japanese population. We performed a subanalysis using baseline data of FCCS study to determine the performance of cytology, the human papillomavirus (HPV) testing and cotesting with cytology and HPV testing, and to evaluate whether the stratification of HPV16, HPV18, and 12 other hrHPV types appropriately balances risks and harms in the Japanese cancer screening population. Methods:The study enrolled 7,584 women aged 25 years or older undergoing routine screening. All women underwent liquid-based cytology (LBC) and cobas HPV testing. Women with abnormal cytology regardless of the HPV status, women with positive hrHPV results regardless of cytology results, and women randomly selected from among those with normal cytology and negative hrHPV results were referred for colposcopy. Results:The prevalence of hrHPV, HPV16, and HPV18 was 6.8%, 1.2%, and 0.5%, respectively. The estimated sensitivities for cervical intraepithelial neoplasia (CIN) 2 or worse for cytology, HPV testing, and cotesting with cytology and HPV testing were 71%, 92%, and 100%, respectively. The estimated positive predictive values for cytology, HPV testing, and cotesting with cytology and HPV testing were 33%, 21% and 21%, respectively. Using a strategy whereby those with abnormal cytology or positive HPV16 genotype undergo colposcopy and biopsy results in a sensitivity of 85% and a positive predictive value of 33%. This strategy results in improved sensitivity while at the same time maintains the positive predictive value compared to screening with cytology alone. Conclusions:Baseline data from the FCCS study suggests that strategy of using colposcopy for women with abnormal cytology and/or HPV16 positivity appropriately balances risks and harms for Japanese women. Clinical trial information: UMIN000025977.

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