Comparison of 18F-FDG PET/MRI and MRI for pre-therapeutic tumor staging of patients with primary cancer of the uterine cervix

Sarabhai, Theresia; Schaarschmidt, Benedikt Michael; Wetter, Axel; Kirchner, Julian; Aktas, Bahriye; Forsting, Michael; Ruhlmann, Verena; Herrmann, Ken; Umutlu, Lale; Grueneisen, Johannes

doi:10.1007/s00259-017-3809-y

Cited by 65 publications

(74 citation statements)

References 33 publications

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“…Recently, the diagnostic potential of integrated PET/MRI has been reported in these situations. Use of 18 F-FDG PET/MRI correctly identi ed T stage (85%) in cervical cancer (22), suggesting that 18 F-FDG PET/MRI might be useful in the local evaluation of the ovarian cancer. In the assessment of T3b and T3c staging, ceCT has been widely used as the standard imaging modality for staging ovarian cancer.…”

Section: Discussionmentioning

confidence: 93%

“…In other cancers, including nasopharyngeal, breast, and colorectal cancers, 18 F-FDG PET/MRI has been reported as superior compared with 18 F-FDG PET/CT for detecting lymph nodes or distant metastasis (25). Moreover, 18 F-FDG PET/MRI has been reported as equivalent to MRI in cervical cancer (22) for the detection of lymph nodes or distant metastasis. Considering the results of the present study, which showed the superiority of 18 F-FDG PET/MRI to ceCT for M staging, 18 F-FDG PET/MRI might offer a useful alternative imaging modality to ceCT, or 18 F-FDG PET/CT in the assessment of N and M staging as well as in the T staging in ovarian cancer.…”

Section: Discussionmentioning

confidence: 99%

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Diagnostic Value of 18F-FDG PET/MRI For Staging in Patients With Ovarian Cancer

Tsuyoshi

Tsujikawa

Yamada

et al. 2020

Preprint

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Purpose To evaluate the diagnostic potential of PET/MRI with 18F-fluorodeoxyglucose (18F-FDG) in ovarian cancer. Materials and Methods Participants comprised 103 patients with suspected ovarian cancer underwent pretreatment 18F-FDG PET/MRI, contrast-enhanced CT (ceCT) and pelvic dynamic contrast-enhanced MRI (ceMRI). Diagnostic performance of 18F-FDG PET/MRI and ceMRI for assessing the characterization and the extent of the primary tumor (T stage) and 18F-FDG PET/MRI and ceCT for assessing nodal (N stage) and distant (M stage) metastases was evaluated by two experienced readers. Histopathological and follow-up imaging results were used as the gold standard. The McNemar test was employed for statistical analysis. Results Accuracy for the characterization of suspected ovarian cancer was significantly better for 18F-FDG PET/MRI (92.5%) than for ceMRI (80.6%; p < 0.05). Accuracy for T status was 96.4% and 92.9% for 18F-FDG PET/MRI and ceMRI/ceCT, respectively. Patient-based accuracies for N and M status were 100% and 100% for 18F-FDG PET/MRI and 85.2% and 30.8% for ceCT and M staging representing significant differences (p < 0.01). Lesion-based sensitivity, specificity and accuracy for N status were 78.6%, 95.7% and 93.9% for 18F-FDG PET/MRI and 42.9%, 96.6% and 90.8% for ceCT. Conclusions Use of 18F-FDG PET/MRI offers higher diagnostic value for the characterization and M staging than ceMRI and ceCT, and diagnostic value for T and N staging equivalent to ceMRI and ceCT, suggesting that 18F-FDG PET/MRI might represent a useful diagnostic alternative to conventional imaging modalities in ovarian cancer.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Diagnostic Value of 18F-FDG PET/MRI For Staging in Patients With Ovarian Cancer

Tsuyoshi

Tsujikawa

Yamada

et al. 2020

Preprint

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“…Extensive literature is found supporting the role of MRI in the pretreatment evaluation of patients with cervical cancer. MRI provided detailed findings being an advanced multi-planar multi-parametric modality that made staging and consequently management much easier procedure in a way that overweighs its high cost [7][8][9][10].…”

Section: Discussionmentioning

confidence: 99%

Impact of diffusion weighted magnetic resonance imaging in diagnosis of cervical cancer

elsalam

Mokhtar

Adel

et al. 2020

Egypt J Radiol Nucl Med

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Background: Cervical cancer is a widespread cancer among women worldwide. In this study, we evaluated the role of diffusion weighted magnetic resonance imaging (DWI-MRI) in diagnosis of cervical carcinoma with pathological diagnosis taken as the reference. The study included 70 patients in whom cancer cervix had been suspected clinically or by transvaginal U/S and confirmed by biopsy. The control group consisted of 40 patients with a normal cervix who performed MRI for other pelvic disorders. Pelvic MR with DWI and dynamic contrast enhanced MRI (DCE-MR) were done for all patients. Results: Both DW-MRI and DCE-MRI revealed the same sensitivity, specificity, PPV, and accuracy; 100%, 50%, 97%, and 97%, respectively. The mean ADC value for malignant lesions was (0.82 × 10 −3 ± 0.1 SD mm 2 /s). While the mean ADC value in the control group is (1.56 × 10-3 mm 2 /s). ADC value of (1.07 × 10 −3 mm 2 /s) is a cutoff between normal cervical tissue& malignant cervical lesion with a sensitivity 97% and specificity 95.5% Conclusion: Each of the (DW-MRI) and (DCE-MRI) sequences when added to the non-contrast MRI sequences in the estimation of cancer cervix had elicited the same sensitivity, specificity, and accuracy. DW-MRI was significantly beneficial in terms of diagnostic performance. For patients who cannot receive contrast medium, dynamic contrastenhanced imaging can be replaced by DWI. The ADC value in case of cervical cancer was significantly lower than in the non-affected cervical tissue.

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“…A specificity of 97% is reported when nodes are defined as metastatic in cases of short-axis larger than 1 cm [23]. In early cervical cancer, the positive predictive value and accuracy of MRI for detecting lymph node metastasis were reportedly 51-76% and 67-76% [7,24]. Lee et al proposed a treatment decision model based on pretreatment MRI findings [25].…”

Section: Discussionmentioning

confidence: 99%

Definitive chemoradiotherapy versus radical hysterectomy followed by tailored adjuvant therapy in women with early-stage cervical cancer presenting with pelvic lymph node metastasis on pretreatment evaluation: A propensity score matching analysis

Park

Kim²,

Song

et al. 2020

Preprint

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Objective To compare the oncologic outcomes between chemoradiotherapy and radical hysterectomy followed by tailored adjuvant therapy in patients with early cervical cancer presenting with pelvic lymph node metastasis. Methods We retrospectively analyzed the medical records of women with early cervical cancer presenting with positive pelvic nodes identified on pretreatment imaging assessment. Propensity score matching was employed to control for the heterogeneity between two groups according to confounding factors. Overall survival, disease-free survival, and pattern of failure were compared between the two groups in all patients as well as the matched cohort. Results A total 262 patients were identified; among them, 67 received definitive chemoradiotherapy (group A) and 195 received hysterectomy (group B). Adjuvant therapy was administered to 88.7% of group B. There were no significant differences between group A and group B regarding the 5-year overall survival rates (89.2% vs. 89.0%) as well as disease-free survival rates (80.6% vs. 82.7) in the entire cohort, and patterns of failure. Distant metastasis was the major failure pattern identified in groups A and B (16.4% and 15.4%). In multivariate analysis, non-squamous histology was significantly associated with poorer overall survival. Conclusion There were no significant differences in oncologic outcomes between definitive chemoradiotherapy and radical hysterectomy followed by tailored adjuvant therapy for early stage cervical cancer patients who had pelvic lymph node metastasis on pretreatment imaging assessment. Definitive chemoradiotherapy could avoid the complication of combined modality therapy without compromising oncologic outcomes.

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Comparison of 18F-FDG PET/MRI and MRI for pre-therapeutic tumor staging of patients with primary cancer of the uterine cervix

Abstract: The present results demonstrate the successful application of integrated PET/MRI imaging for whole-body tumor staging of cervical cancer patients, enabling improved treatment planning when compared to MRI alone.

Cited by 65 publications

References 33 publications

Diagnostic Value of 18F-FDG PET/MRI For Staging in Patients With Ovarian Cancer

Diagnostic Value of 18F-FDG PET/MRI For Staging in Patients With Ovarian Cancer

Impact of diffusion weighted magnetic resonance imaging in diagnosis of cervical cancer

Definitive chemoradiotherapy versus radical hysterectomy followed by tailored adjuvant therapy in women with early-stage cervical cancer presenting with pelvic lymph node metastasis on pretreatment evaluation: A propensity score matching analysis

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