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

Abstract

ObjectiveTo evaluate the indications for performing magnetic resonance imaging of the female pelvis at a referral center for cancer.Materials and MethodsThis 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.ResultsThe 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%).ConclusionIn 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.

Indications for magnetic resonance imaging of the female pelvis at a referral center for cancer

“…As observed by the authors of the cited study ( 1 ) , one of the main indications for MRI of the female pelvis is for the diagnosis or oncological follow-up of primary gynecological lesions. In relation to primary uterine lesions, diffusion-weighted imaging facilitates the identification of tumors in the uterine body and cervix ( 4 ) .…”

“…Guidelines that review the criteria and technical parameters for indicating and conducting diagnostic imaging can optimize radiology care. In an article published in this issue of Radiologia Brasileira , the criteria established by the American College of Radiology for conducting magnetic resonance imaging (MRI) examinations of the female pelvis were compared with those employed at a national referral center for cancer in Brazil ( 1 ) . The results were compatible with those of the renowned American institution and show that MRI was correctly indicated in most (76.7%) of the patients.…”

Subpubic cartilaginous cyst: a rare cause of vulvar lesion

“…Imaging exams, MRI in particular, have garnered increasing attention in the assessment of pelvic diseases (6)(7)(8)(9)(10) . A diagnosis of SCC, which is based on clinical and imaging findings, depends on the amount of mucinous and cartilaginous material, which results in a heterogeneous aspect on MRI (2,11) .…”

“…Preoperative biopsies of SCCs are reserved for cases in which there is a high suspicion of malignancy (1,6) . The treatment of choice is resection, because the bulky content of the cyst precludes aspiration.…”

Transvaginal ultrasound in deep endometriosis: pictorial essay

“…Endometriosis has a significant impact on the quality of life of women. In addition to the characteristic symptoms (dysmenorrhea, pelvic pain, dyspareunia, urinary changes, and intestinal alterations), it causes psychological, marital, and social distress ( 1 ) .…”