Evaluation of a New Prognostic Tumor Score in Locally Advanced Cervical Cancer Integrating Clinical Examination and Magnetic Resonance Imaging

Lindegaard, Jacob Christian; Petric, Primoz; Lindegaard, Anne Marie; Tanderup, Kari; Fokdal, Lars

doi:10.1016/j.ijrobp.2019.11.031

Cited by 15 publications

(14 citation statements)

References 28 publications

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“…During preoperative assessment of cervical cancer, clinical examinations are considerably influenced by the clinical competence of doctors and other subjective factors, commonly resulting in failure to accurately assess tumor size and obtain information on tumor invasion into adjacent tissues (9). Imaging techniques counteract the deficiencies of clinical examinations by enabling visualization of local cervical lesions and pelvic conditions more objectively and the superior soft tissue resolution of MRI can provide enhanced details for cervical cancer staging diagnosis (10).…”

Section: Discussionmentioning

confidence: 99%

Value of diffusion-weighted imaging in preoperative evaluation and prediction of postoperative supplementary therapy for patients with cervical cancer

Liu¹,

Wang²,

Yu³

et al. 2022

Ann Transl Med

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Background: With the continuous progress of medical imaging technology, evaluation of cervical cancer is increasingly dependent on imaging methods. Diffusion-weighted imaging (DWI) plays an important role, and apparent diffusion coefficient (ADC) value is a unique quantitative parameter in the research of cervical cancer. Methods:In this prospective study, a total of 273 patients diagnosed with stage IB1 to IIIC1 cervical cancer based on the International Federation of Gynecology and Obstetrics (FIGO) 2018 staging guidelines who underwent pelvic 3.0T magnetic resonance imaging (MRI), including MRI and DWI, were enrolled, and the diagnostic value of preoperative staging of cervical cancer was compared between the MRI and DWI groups.The DWI group was used to explore the potential association of mean ADC (ADC mean ) with different pathological characteristics and receiver operating characteristic (ROC) curves of ADC mean generated to predict the appropriate postoperative supplementary therapy. Results:The diagnostic coincidence rate of DWI was higher than that of MRI in preoperative staging of cervical cancer (χ 2 , P<0.05) and determined as stages IB1 + IB2 + IIA1 (90.91%), IB3 + IIA2 (93.48%), and IIIC1p (95.16%). The DWI staging results were consistent with postoperative pathological staging (Kappa value =0.865, P<0.001). We observed significant differences in ADC mean values in relation to pathological type, histological grade, depth of stromal infiltration, tumor diameter, lymphovascular invasion, and pelvic lymph node metastasis of cervical cancer (all P<0.05). The area under the ROC curve (AUC) was 0.815, with the best predictive value for postoperative supplementary therapy in cervical cancer (sensitivity 80.0%, specificity 74.0%) at ADC mean of 0.910×10 −3 mm 2 /s. Conclusions:The DWI is a useful tool for preoperative evaluation of cervical cancer. In local cervical lesions, ADC mean varies in relation to different clinicopathological characteristics and a reference index of <0.910×10 −3 mm 2 /s can be effectively applied to predict the need for postoperative supplementary therapy.

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Section: Discussionmentioning

confidence: 99%

Value of diffusion-weighted imaging in preoperative evaluation and prediction of postoperative supplementary therapy for patients with cervical cancer

Liu¹,

Wang²,

Yu³

et al. 2022

Ann Transl Med

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“…This indicates the importance of controlling the primary cervical tumour and preventing metastatic seeding. With regard to improved local control, several studies stress the importance of image guided adaptive brachytherapy including maturing data from Retro-EMBRACE and EMBRACE I (3,38,39).…”

Section: Discussionmentioning

confidence: 99%

Risk factors for nodal failure after radiochemotherapy and image guided brachytherapy in locally advanced cervical cancer: An EMBRACE analysis

Peters

Leeuw

Nomden

et al. 2021

Radiotherapy and Oncology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…A combination of a detailed clinical examination and MRI findings (quantifying e.g. proximal/distal parametrial or uterine infiltration which are currently not reflected by TNM or FIGO) into one final quantitative score for local tumour assessment ("T-score") was recently suggested by Lindegaard et al and seems to be valuable for prognosis [21].…”

Section: Discussionmentioning

confidence: 99%

“…It appears that the optimal tumour classification system for cervical cancer still needs to be developed. The proposed comprehensive quantitative "T-score" [21] in combination with the nodal status may offer possible discussion pathways.…”

Section: Discussionmentioning

confidence: 99%

Clinical and imaging findings in cervical cancer and their impact on FIGO and TNM staging – An analysis from the EMBRACE study

Knoth

Pötter

Jürgenliemk-Schulz

et al. 2020

Gynecologic Oncology

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Local stage of advanced cervical cancer changes in 27% comparing MRI and clinical examination.• For treatment allocation important clinical stages IB1-IIA2 changed to IIB on MRI in 31%.• Pelvic wall/bladder infiltration vary considerably, likely due to different definitions for clinical and imaging findings. • 50% of this cohort are allocated to stage IIIC with FIGO 2018, obscuring local tumour extent.• TNM offers the most differentiated stage allocation with 26 subgroups in this cohort.

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Evaluation of a New Prognostic Tumor Score in Locally Advanced Cervical Cancer Integrating Clinical Examination and Magnetic Resonance Imaging

Cited by 15 publications

References 28 publications

Value of diffusion-weighted imaging in preoperative evaluation and prediction of postoperative supplementary therapy for patients with cervical cancer

Value of diffusion-weighted imaging in preoperative evaluation and prediction of postoperative supplementary therapy for patients with cervical cancer

Risk factors for nodal failure after radiochemotherapy and image guided brachytherapy in locally advanced cervical cancer: An EMBRACE analysis

Clinical and imaging findings in cervical cancer and their impact on FIGO and TNM staging – An analysis from the EMBRACE study

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