Cervical cancer is the second most common cancer after breast cancer and the third most common cause of cancer-related death followed by breast and lung cancers among women worldwide. advances in diagnostic imaging techniques provide better assessment of regional and distant cervical cancer metastasis. the use of contrast-enhanced ultrasound is a revolutionary imaging modality; it has several advantages over ct: no radiation exposure, nephrotoxicity, obtaining real-time information, relatively low cost and ease of use. currently, the contrast agent sonoVue is widely used in ultrasound imaging of liver, kidneys and pancreas lesions, as well as for closed abdominal injuries, multiple organ failure, breast and prostate cancers, etc. However, the role of contrast-enhanced ultrasound in gynecology is not clearly established. one of the most effective tools for the detection of locally advanced cervical cancer is mRi, which is used mainly to determine the local extent of the tumor. However, the use of functional mRitechniques has not yet been included in the standards. cervical cancer tissue has been found to show significantly lower diffusion-weighted imaging (dWi) values than normal cervical tissue, thus facilitating the detection of tumor and its spread. dWiis also used for differentiating changes after biopsy from residual tumor and for identifying small lymph nodes. the pEt/cttechnique combines the metabolic images of pEtwith anatomical images of ctand is more accurate than high resolution ctalone, especially in determining the involvement of regional lymph nodes and distant organs. 18-Fdg-pEt/cthas been successfully used for accurate staging of the disease (especially late stage), assessment of treatment response, radiotherapy planning, and detection of disease progression. in patients with advanced stages of cervical cancer (iiBiV stage), the 18-Fdg-pEt/ ctfindings can determine the treatment strategy in most cases, primarily due to high sensitivity (75–100 %) and specificity (87–100 %) in the detection of lymph node metastases.
Objective: to evaluate the diagnostic capabilities of the dynamic magnetic-resonance cystography technique in detecting invasion of perivesical fat in case of bladder cancer.Materials and methods. The study included 125 patients (105 male and 20 females, mean 62.6 Ѓ} 11.0 years) with transitional cell carcinoma of the bladder. To assess the accuracy of the dynamic cystography method, cases with a tumor size of more than 20 mm, affecting the wall outside the bladder triangle, were selected with suspicion of perivesical fat invasion on magnetic-resonance scans. A furacilin solution was fractional injected into the catheterized bladder to obtain repeated series of T2‑haste-FS images until the bladder was completely expanded.Results. In postprocessing, the selection of areas of interest (ROI) was performed along the contour of the affected wall in the cross section through the center of the tumor. Comparison of the displacement of the affected and intact walls by a diagram of the values of the intensity of the magnetic-resonance signal in the dynamics of bladder dilatation was evaluated. The verification method was the morphological study of the surgical material after the operative treatment. The limit of values with a more likely lesion of perivesical fat was found, which is less than 11 % of the intensity change of the magnetic-resonance signal in selected ROIs during bladder wall expansion.Conclusion. The effectiveness of dynamic magnetic-resonance cystography in the differential diagnosis of perivesical fat infiltration in bladder cancer is characterized by a sensitivity of 90.0 %, a specificity of 93.3 %, and an accuracy of 92.0 %. The proposed technique improves the accuracy of the magnetic resonance imaging method with suspected infiltration of perivesical fat and is well tolerated by patients.
This scientific review assesses the current diagnostic capabilities of diffusion-weighted images used in the magnetic resonance imaging protocol for bladder cancer. It actualizes this impulse sequence employed within the framework of a multiparametric MRI study as one of the functional techniques. The review deals with the possibilities of diffusion-weighted images used in an independent version and in combination with T2-weighted images to visualize a tumor, postoperative changes, and associated pathology. It gives differential diagnostic criteria in identifying the extent of tumor invasion, including that with accuracy assessment according to the measured diffusion coefficient.The sources of the review are publications included in the peer-reviewed databases PubMed, Scopus, eLIBRARY and the open sources Google Scholar, Researchgate.
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