Can MRI rule out bladder and rectal invasion in cervical cancer to help select patients for limited EUA?

Rockall, Andrea; Ghosh, Saptarshi; Alexander-Sefre, Farhad; Babar, Syed; YOUNIS, MOHAMED; Naz, Samia; Jacobs, Ian; Reznek, Rodney H.

doi:10.1016/j.ygyno.2005.10.012

Cited by 95 publications

(63 citation statements)

References 19 publications

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“…Among those 7 centres that use IV contrast medium, 6 use a dynamic acquisition and 1 uses a semidynamic one. The results of the literature are also variable with some authors using IV contrast medium systematically in all cases [10][11][12] whereas other authors not using IV contrast medium at all [13,14]. In a dynamic acquisition, contrast enhancement of the tumour is lower than the myometrium in the early phase, whereas on the late phases, tumour signal intensity is higher than the myometrium.…”

Section: B Use Of Intravenous Contrast Mediummentioning

confidence: 99%

Staging of uterine cervical cancer with MRI: guidelines of the European Society of Urogenital Radiology

Balleyguier

Sala

Cunha³

et al. 2010

Eur Radiol

264

199

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Objective: To design clear guidelines for the staging and follow-up of patients with uterine cervical cancer, and to provide the radiologist with a framework for use in multidisciplinary conferences. Methods: Guidelines for uterine cervical cancer staging and follow-up were defined by the female imaging subcommittee of the ESUR (European Society of Urogenital Radiology) based on the expert consensus of imaging protocols of 11 leading institutions and a critical review of the literature. Results: The results indicated that high field Magnetic Resonance Imaging (MRI) should include at least two T2-weighted sequences in sagittal, axial oblique or coronal oblique

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Section: B Use Of Intravenous Contrast Mediummentioning

confidence: 99%

Staging of uterine cervical cancer with MRI: guidelines of the European Society of Urogenital Radiology

Balleyguier

Sala

Cunha³

et al. 2010

Eur Radiol

264

199

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“…One study, which adopted the cystoscopic finding as a reference standard for ''bladder invasion'', measured the performance of MRI using the MRI finding of not only mucosal invasion but also serosal and/or muscular invasion. These authors accepted a PPV of 7% to obtain an NPV of 100% [6]. To explain the low PPV in their study, they suggested two possibilities; namely, cystoscopic misdiagnosis and correct but undetectable serosal and/or muscular invasion.…”

Section: Significance Of Bladder Wall Invasion On Mri In Cervical Cancermentioning

confidence: 93%

“…shows a high diagnostic accuracy for the exclusion of bladder involvement, with negative predictive values (NPV) of 96-100% [6][7][8][9][10]. This high NPV for bladder invasion suggests that the low pre-test probability of bladder involvement in early stage cervical cancer does not justify routine cystoscopy [7,13].…”

Section: Significance Of Bladder Wall Invasion On Mri In Cervical Cancermentioning

confidence: 99%

“…This high NPV for bladder invasion suggests that the low pre-test probability of bladder involvement in early stage cervical cancer does not justify routine cystoscopy [7,13]. However, for the positive predictive value (PPV) of MRI for bladder invasion, studies show highly discrepant values ranging from 7% to 100% [6][7][8][9][10]. Heterogeneity in the reference standard and differences between studies in MRI interpretation may largely explain this.…”

Section: Significance Of Bladder Wall Invasion On Mri In Cervical Cancermentioning

confidence: 99%

“…With regard to bladder invasion, studies specifically tested the diagnostic accuracy of MRI against cystoscopic examination and/or surgical sampling as reference standards [6][7][8][9][10]. However, non-mucosal invasion cannot be diagnosed with cystoscopy, but can be confirmed only by exploration, which is not usually performed for locally advanced cervical cancer.…”

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confidence: 99%

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Prognostic significance of MRI-detected bladder muscle and/or serosal invasion in patients with cervical cancer treated with radiotherapy

Nam

Huh²,

Park³

et al. 2010

British Journal of Radiology

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ABSTRACT. In cervical cancer, the prognostic significance of bladder wall invasion on MRI without pathological evidence of mucosal invasion is not known. From 454 consecutive patients with cervical cancer who were treated with radiation, we reviewed images and analysed the outcome of 92 patients with the Federation of International Gynecology and Obstetrics (FIGO) stage IIIB-IVA. We analysed the patients in three groups, normal, wall (muscle and/or serosal) invasion and mucosal invasion, according to the findings on the MRI. Kaplan-Meier life table analysis and the log-rank test were used to assess the survival rates and differences according to prognostic factors. MRI detected abnormalities in the bladder wall in 42 patients (45.6%): wall invasion in 24 and mucosal invasion in 18. 5 of 18 patients, suspected on MRI to have mucosal invasion, showed no pathological evidence of mucosal invasion. Median follow-up period was 34 months. 3-year cause-specific survival (CSS) in the normal group compared with the wall invasion group was 76.2% vs 71.4% (p50.48). 3-year CSS for the wall invasion group compared with the mucosal invasion group was 71.4% vs 54.3% (p50.04). Mucosal invasion on MRI (p50.03) and concurrent chemoradiotherapy (p50.01) was significant for CSS. The prognosis for patients with cervical cancer with evidence of muscle and/or serosal invasion of the bladder on MRI may not differ from that for patients without abnormality on MRI. In patients with the MRI finding of bladder mucosal invasion, further studies should be conducted regarding the role of cystoscopy to determine the need for pathological confirmation.

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Gastrointentinal Manifestations of Systemic Diseases

Israeli

Bernstein

2015

Yamada' S Textbook of Gastroenterology

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Can MRI rule out bladder and rectal invasion in cervical cancer to help select patients for limited EUA?

Cited by 95 publications

References 19 publications

Staging of uterine cervical cancer with MRI: guidelines of the European Society of Urogenital Radiology

Staging of uterine cervical cancer with MRI: guidelines of the European Society of Urogenital Radiology

Prognostic significance of MRI-detected bladder muscle and/or serosal invasion in patients with cervical cancer treated with radiotherapy

Gastrointentinal Manifestations of Systemic Diseases

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