Diagnostic Accuracy of Magnetic Resonance Imaging versus Clinical Staging in Cervical Cancer

Shirazi, A Soltani; Razi, T. Khairol; Cheraghi, Fatemeh; Rahim, Fakher; Ehsani, Sara; Davoodi, Mohammad

doi:10.7314/apjcp.2014.15.14.5729

Cited by 14 publications

(12 citation statements)

References 19 publications

(29 reference statements)

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“…The current study detected extension of the mass in cervix into corpus of uterus in 51.4% patients, into rectal musculature or mucosa in 5.7% patients and into mucosa or muscle of urinary bladder in 8.6% patients. The accuracy, specificity and NPV is almost agreeing with the studies of Shweel et al and Shirazi et al 12 Parametrial extension in a case of carcinoma cervix can be excluded if the hypointense stromal signal intensity is preserved on T2WI. Parametrial involvement is said to be present when there is a spiculated margin replacing the hypointense signal on T2WI.…”

Section: Discussionsupporting

confidence: 88%

Role of Mri in Staging of Carcinoma Cervix

Beerappa¹,

Kapali²,

Pream³

et al. 2016

jebmh

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Cervical carcinoma continues to be staged according to the clinical FIGO classification system which is not accurate. In our study, we determined the diagnostic accuracy of MRI in staging carcinoma cervix with same parameters as FIGO staging. AIMS In our study, we determined the diagnostic accuracy of MRI in staging carcinoma cervix, adjoining organ infiltration and delineating stage IIA and below from rest of the stages in carcinoma cervix. SETTINGS Study was done in the Department of Radiodiagnosis, in a tertiary care government hospital on 70 female patients diagnosed with carcinoma cervix. DESIGN Hospital based observational study. MATERIALS AND METHODS MRI staging was correlated with surgico-pathological findings when patient underwent surgery. MRI staging was compared to the non-pathological staging when patient underwent radiotherapy or neoadjuvant chemotherapy. STATISTICAL ANALYSIS Univariate and bivariate frequency tables are generated. Sensitivity, specificity and accuracy of MRI in staging of carcinoma cervix are calculated. Interclass correlation is done with Pearson's correlation coefficient , p value ≤ 0.05 was considered statistically significant. RESULTS MRI has a sensitivity, specificity, PPV, NPV and accuracy of 88.7%, 87.5%, 98.2%, 50% and 88.6% respectively [with interclass correlation coefficient r=0.982, p<0.01 95% CI (0.972-0.989)] in staging of carcinoma cervix. CONCLUSIONS MRI in staging carcinoma cervix is preferred to clinical FIGO staging for deciding on the treatment modality. However, MRI is not a good modality in detecting carcinoma in situ [stage 0] and stage I of carcinoma cervix.

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Section: Discussionsupporting

confidence: 88%

Role of Mri in Staging of Carcinoma Cervix

Beerappa¹,

Kapali²,

Pream³

et al. 2016

jebmh

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“…In studies by Hricak et al and Mitchell et al, in locally advanced cervical cancers, imaging modalities were superior for staging purposes (Hricak et al, 2005;Mitchell et al, 2006;Shirazi et al, 2014). In contrast, clinical staging was found to be more effective in a study by Hancke et al (Hancke et al, 2008).…”

Section: Discussionmentioning

confidence: 97%

Effect of Hydronephrosis on Survival in Advanced Stage Cervical Cancer

Goklu

Seçkin²,

Toğrul³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Background: Hydronephrosis is frequently encountered in advanced stage cervical cancers, and may be associated with mortality. In the present study, we aimed to demonstrate the effect of hydronephrosis on survival in patients with inoperable advanced stage cervical cancer. Materials and Methods: The study data were acquired by retrospective analysis of the patient records belonging to 165 women with FIGO (International Federation of Gynecology and Obstetrics) stage-IIIB or more advanced cervical cancer, which were not surgical candidates. Parameters including patient age, pathological diagnosis, disease stage, pelvic sidewall extension, presence of hydronephrosis and administration of chemoradiation were analyzed. Further, the effects of these variables on survival were assessed. P values less than 0.05 were considered statistically significant. Results: The distribution of the study patients according to disease stage was as follows: 131 (79.4%) had stage-IIIB, 18 (10.9%) had stage-IVB and 16 (% 9.7) patients had stage-IVA disease. Hydronephrosis was not evident in 91 (55.2%) of these patients, whereas 41 (24.8%) had unilateral and 33 (20%) patients had bilateral hydronephrosis. When compared to mean survival in patients who did not have hydronephrosis, survival was significantly shortened in patients who had bilateral and unilateral hydronephrosis (p < 0.05). There was no significant survival difference between patients with unilateral and bilateral hydronephrosis (p>0.05). Although patient age, pathological type, pelvic involvement, and chemotherapy treatment rates were similar (p>0.05), radiotherapy requirement rate and disease stage were significantly different among the study groups (p<0.05). Conclusions: Hydronephrosis was found to be a significant predictor of poor survival in patients with advanced stage cervical cancer, irrespective of unilateral or bilateral involvement.While waiting for future studies with larger sample sizes, we believe that the FIGO stages in advanced cervical cancer could further be stratified into subgroups according to presence or absence of hydronephrosis.

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“… 1 The treatment of cervical cancer involves surgery and chemoradiotherapy, which depends on early detection and accurate staging, especially the lymph node involvement. 2 – 4 Lymph node metastasis (LNM) is not only closely related to cervical cancer recurrence and distant metastasis, but also an independent factor in poor survival. Furthermore, lymphovascular space invasion (LVSI) not only was an independent influencing factor for LNM but also has been well considered for treatment cervical cancer now.…”

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confidence: 99%

Tumor Size at Magnetic Resonance Imaging Association With Lymph Node Metastasis and Lymphovascular Space Invasion in Resectable Cervical Cancer: A Multicenter Evaluation of Surgical Specimens

Chen

et al. 2018

Int J Gynecol Cancer

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ObjectiveTo determine whether gross tumor volume (GTV) and the maximum diameter of resectable cervical cancer at magnetic resonance imaging (MRI) could predict lymph node metastasis (LNM) and lymphovascular space invasion (LVSI).Materials and MethodsA total of 315 consecutive patients with cervical cancer were retrospectively identified. Gross tumor volume and the maximum diameter of tumor were evaluated on MRI. Univariate and multivariate logistic regression analyses were performed to determine whether tumor size could predict LNM and LVSI. Cutoffs of GTV, maximum diameter, and the International Federation of Gynecology and Obstetrics (FIGO) classification of tumor were first investigated in 255 patients (group A) and then validated in an independent cohort of 60 patients (group B) using area under the receiver operating characteristic curve (AUC) analysis for predicting the presence of LNM and LVSI.ResultsUnivariate analysis showed that GTV and the maximum diameter of tumor could predict LNM and LVSI (all P < 0.0001). Multivariate analyses indicated GTV as an independent risk factor of LNM and LVSI (all P < 0.0001). In group A, GTV, the maximum diameter, and the FIGO stage could identify LNM (AUC, 0.813, 0.741, and 0.69, respectively) and LVSI (AUC, 0.806, 0.751, and 0.684, respectively). In group B, GTV, the maximum diameter, and the FIGO stage could help identify LNM (AUC, 0.902, 0.825, and 0.759, respectively) and LVSI (AUC, 0.771, 0.748, and 0.700, respectively).ConclusionsGross tumor volume and the maximum diameter of resectable cervical cancer at MRI demonstrated capability in predicting LNM and LVSI, which were more accurate than FIGO stage.

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Diagnostic Accuracy of Magnetic Resonance Imaging versus Clinical Staging in Cervical Cancer

Cited by 14 publications

References 19 publications

Role of Mri in Staging of Carcinoma Cervix

Role of Mri in Staging of Carcinoma Cervix

Effect of Hydronephrosis on Survival in Advanced Stage Cervical Cancer

Tumor Size at Magnetic Resonance Imaging Association With Lymph Node Metastasis and Lymphovascular Space Invasion in Resectable Cervical Cancer: A Multicenter Evaluation of Surgical Specimens

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