Diagnostic Value of Magnetic Resonance Imaging (MRI), Computed Tomography
(CT) and Positron Emission Tomography (PET) in the Detection of Lymph Node
Metastases in Gynaecologic Cancers

Background: A factor that affects the staging of gynaecological cancers is the status of adenopathy’s and imaging tests are a fundamental part of staging. Primary Objective: To assess the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) in the detection of pathological lymphadenopathies in gynaecological cancers of magnetic resonance imaging (MRI), computerized axial tomography (CAT) and positrons emission tomography (PET). Study Hypothesis: Imaging tests are not as valid as lymphadenectomy for the diagnosis of pathological lymphadenopathies. Trial Design: Retrospective study performed in the gynaecological oncology unit of a tertiary hospital. Major Inclusion/Exclusion Criteria: Patients diagnosed with genital cancer (endometrium, ovary or cervix) in the period between January 1, 2014 and December 31, 2018, who meet the following inclusion criteria: (i) have requested a diagnostic test of image (RNM, CT or PET-CT) prior to undergoing surgery; (ii) have undergone surgery for the treatment of cancer and (iii) have undergone lymphadenectomy, pelvic and / or para-aortic, during surgery. Primary Endpoint: Correlation between the imaging tests and the anatomopathological result of the lymph node biopsies. Sample Size: 219 patients who underwent pelvic, para-aortic lymphadenectomy or both due to cancer of the endometrium, ovary or cervix, and at least one imaging test prior to surgery. Results: In our study, PET presents the highest sensitivity (42%) of the diagnostic tests evaluated, the TAC the highest specificity (95%) and the highest PPV (77%) and the MRI the highest NPV (76%). Conclusions: The diagnostic value of imaging tests in the detection of lymph node metastases in gynaecological cancers is limited.

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Diagnostic Performance of Nanoparticle-Enhanced Magnetic Resonance Imaging in the Diagnosis of Lymph Node Metastases in Patients With Endometrial and Cervical Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2005.07.166 ◽

2005 ◽

Vol 23 (12) ◽

pp. 2813-2821 ◽

Cited By ~ 259

Author(s):

Andrea G. Rockall ◽

Syed A. Sohaib ◽

Mukesh G. Harisinghani ◽

Syed A. Babar ◽

Naveena Singh ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Lymph Node ◽

Magnetic Resonance ◽

Lymph Node Metastases ◽

Predictive Value ◽

Diagnostic Performance ◽

Resonance Imaging ◽

Lymph Node Sampling ◽

Node Metastases ◽

Sensitivity Specificity

Purpose Lymph node metastases affect management and prognosis of patients with gynecologic malignancies. Preoperative nodal assessment with computed tomography or magnetic resonance imaging (MRI) is inaccurate. A new lymph node–specific contrast agent, ferumoxtran-10, composed of ultrasmall particles of iron oxide (USPIO), may enhance the detection of lymph node metastases independent of node size. Our aim was to compare the diagnostic performance of MRI with USPIO against standard size criteria. Methods Forty-four patients with endometrial (n = 15) or cervical (n = 29) cancer were included. MRI was performed before and after administration of USPIO. Two independent observers viewed the MR images before lymph node sampling. Lymph node metastases were predicted using size criteria and USPIO criteria. Lymph node sampling was performed in all patients. Results Lymph node sampling provided 768 pelvic or para-aortic nodes for pathology, of which 335 were correlated on MRI; 17 malignant nodes were found in 11 of 44 patients (25%). On a node-by-node basis, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) by size criteria were 29%*, 99%, 56%, and 96%, and by USPIO criteria (reader 1/reader 2) were 93%/82%* (*P = .008/.004), 97%/97%, 61%/59%, and 100%/99%, respectively (where [*] indicates the statistical difference of P = x/x between the two results marked by the asterisk). On a patient-by-patient basis, sensitivity, specificity, PPV, and NPV by size criteria were 27%*, 94%, 60%, and 79%, and by USPIO criteria (reader 1/reader 2) were 100%/91%* (*P = .031/.06), 94%/87%, 82%/71%, and 100%/96%, respectively. The κ statistic was 0.93. Conclusion Lymph node characterization with USPIO increases the sensitivity of MRI in the prediction of lymph node metastases, with no loss of specificity. This may greatly improve preoperative treatment planning.

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Imaging of larynx: Diagnostic value of computed tomography and magnetic resonance imaging

Acta chirurgica iugoslavica ◽

10.2298/aci0903039m ◽

2009 ◽

Vol 56 (3) ◽

pp. 39-44

Author(s):

R.M. Maksimovic ◽

B.A. Banko ◽

J.P. Milovanovic

Keyword(s):

Magnetic Resonance Imaging ◽

Computed Tomography ◽

Magnetic Resonance ◽

Regional Lymph Node ◽

Diagnostic Value ◽

Resonance Imaging ◽

Precise Diagnosis ◽

Node Metastases ◽

Magnetic Resonance Imaging Mri

Computed tomography (CT) and magnetic resonance imaging (MRI) are enabling more precise diagnosis and treatment planning in patients with diseases of the larynx. The aim of this article is to describe the role of these methods in assessment of the laringeal diseases and key local anatomic characteristics important for spread of the disease. CT and MRI have a valuable contribution to the staging of the tumors due to the possibility to show the relationship to the ventricular complex, involvement of the subumucosal spaces, defining craniocaudal and anterposterior extension, laringeal cartilage invasion, as well as regional lymph node metastases.

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