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Role of Diffusion Weighted Imaging and Contrast-Enhanced MRI in the Evaluation of Intrapelvic Recurrence of Gynecological Malignant Tumor
BACKGROUND AND PURPOSE: To investigate the diagnostic performance of diffusion-weighted imaging (DWI) and contrast-enhanced imaging in combination with T2-weighted imaging (T2WI) for magnetic resonance imaging (MRI) evaluation of intrapelvic recurrence of gynecological malignancies. MATERIALS AND ME...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4309401/ https://www.ncbi.nlm.nih.gov/pubmed/25629156 http://dx.doi.org/10.1371/journal.pone.0117411 |
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author | Kitajima, Kazuhiro Tanaka, Utaru Ueno, Yoshiko Maeda, Tetsuo Suenaga, Yuko Takahashi, Satoru Deguchi, Masashi Miyahara, Yoshiya Ebina, Yasuhiko Yamada, Hideto Tsurusaki, Masakatsu Tamaki, Yukihisa Sugimura, Kazuro |
author_facet | Kitajima, Kazuhiro Tanaka, Utaru Ueno, Yoshiko Maeda, Tetsuo Suenaga, Yuko Takahashi, Satoru Deguchi, Masashi Miyahara, Yoshiya Ebina, Yasuhiko Yamada, Hideto Tsurusaki, Masakatsu Tamaki, Yukihisa Sugimura, Kazuro |
author_sort | Kitajima, Kazuhiro |
collection | PubMed |
description | BACKGROUND AND PURPOSE: To investigate the diagnostic performance of diffusion-weighted imaging (DWI) and contrast-enhanced imaging in combination with T2-weighted imaging (T2WI) for magnetic resonance imaging (MRI) evaluation of intrapelvic recurrence of gynecological malignancies. MATERIALS AND METHODS: Sixty-two patients with suspected intrapelvic recurrence of gynecological malignancies underwent pelvic MRI including T2WI DWI, and contrast-enhanced imaging. Diagnostic performance for detection of local recurrence, pelvic lymph node and bone metastases, and peritoneal lesions was evaluated by consensus reading of two experienced radiologists using a 5-point scoring system, and compared among T2WI with unenhanced T1-weighted imaging (T1WI) (protocol A), a combination of protocol A and DWI (protocol B), and a combination of protocol B and contrast-enhanced imaging (protocol C). Final diagnoses were obtained by histopathological examinations, radiological imaging and clinical follow-up for at least 6 months. Receiver operating characteristic (ROC) analysis and McNemar test were employed for statistical analysis. RESULTS: Locally recurrent disease, lymph node recurrence, peritoneal dissemination and bone metastases were present in 48.4%, 29.0%, 16.1%, and 6.5% of the patients, respectively. The patient-based sensitivity, specificity, accuracy, and area under the ROC curve (AUC) for detection of intrapelvic recurrence were 55.0, 81.8, 64.5% and 0.753 for protocol A, 80.0, 77.3, 79.0% and 0.838 for protocol B, and 80.0, 90.9, 83.9% and 0.862 for protocol C, respectively. The sensitivity, accuracy, and AUC were significantly better for protocols B and C than for protocol A (p<0.001). There was no significant difference between protocols B and C. CONCLUSION: MRI using a combination of DWI and T2WI gives comparatively acceptable results for assessment of intrapelvic recurrence of gynecological malignancies. |
format | Online Article Text |
id | pubmed-4309401 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-43094012015-02-06 Role of Diffusion Weighted Imaging and Contrast-Enhanced MRI in the Evaluation of Intrapelvic Recurrence of Gynecological Malignant Tumor Kitajima, Kazuhiro Tanaka, Utaru Ueno, Yoshiko Maeda, Tetsuo Suenaga, Yuko Takahashi, Satoru Deguchi, Masashi Miyahara, Yoshiya Ebina, Yasuhiko Yamada, Hideto Tsurusaki, Masakatsu Tamaki, Yukihisa Sugimura, Kazuro PLoS One Research Article BACKGROUND AND PURPOSE: To investigate the diagnostic performance of diffusion-weighted imaging (DWI) and contrast-enhanced imaging in combination with T2-weighted imaging (T2WI) for magnetic resonance imaging (MRI) evaluation of intrapelvic recurrence of gynecological malignancies. MATERIALS AND METHODS: Sixty-two patients with suspected intrapelvic recurrence of gynecological malignancies underwent pelvic MRI including T2WI DWI, and contrast-enhanced imaging. Diagnostic performance for detection of local recurrence, pelvic lymph node and bone metastases, and peritoneal lesions was evaluated by consensus reading of two experienced radiologists using a 5-point scoring system, and compared among T2WI with unenhanced T1-weighted imaging (T1WI) (protocol A), a combination of protocol A and DWI (protocol B), and a combination of protocol B and contrast-enhanced imaging (protocol C). Final diagnoses were obtained by histopathological examinations, radiological imaging and clinical follow-up for at least 6 months. Receiver operating characteristic (ROC) analysis and McNemar test were employed for statistical analysis. RESULTS: Locally recurrent disease, lymph node recurrence, peritoneal dissemination and bone metastases were present in 48.4%, 29.0%, 16.1%, and 6.5% of the patients, respectively. The patient-based sensitivity, specificity, accuracy, and area under the ROC curve (AUC) for detection of intrapelvic recurrence were 55.0, 81.8, 64.5% and 0.753 for protocol A, 80.0, 77.3, 79.0% and 0.838 for protocol B, and 80.0, 90.9, 83.9% and 0.862 for protocol C, respectively. The sensitivity, accuracy, and AUC were significantly better for protocols B and C than for protocol A (p<0.001). There was no significant difference between protocols B and C. CONCLUSION: MRI using a combination of DWI and T2WI gives comparatively acceptable results for assessment of intrapelvic recurrence of gynecological malignancies. Public Library of Science 2015-01-28 /pmc/articles/PMC4309401/ /pubmed/25629156 http://dx.doi.org/10.1371/journal.pone.0117411 Text en © 2015 Kitajima et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Kitajima, Kazuhiro Tanaka, Utaru Ueno, Yoshiko Maeda, Tetsuo Suenaga, Yuko Takahashi, Satoru Deguchi, Masashi Miyahara, Yoshiya Ebina, Yasuhiko Yamada, Hideto Tsurusaki, Masakatsu Tamaki, Yukihisa Sugimura, Kazuro Role of Diffusion Weighted Imaging and Contrast-Enhanced MRI in the Evaluation of Intrapelvic Recurrence of Gynecological Malignant Tumor |
title | Role of Diffusion Weighted Imaging and Contrast-Enhanced MRI in the Evaluation of Intrapelvic Recurrence of Gynecological Malignant Tumor |
title_full | Role of Diffusion Weighted Imaging and Contrast-Enhanced MRI in the Evaluation of Intrapelvic Recurrence of Gynecological Malignant Tumor |
title_fullStr | Role of Diffusion Weighted Imaging and Contrast-Enhanced MRI in the Evaluation of Intrapelvic Recurrence of Gynecological Malignant Tumor |
title_full_unstemmed | Role of Diffusion Weighted Imaging and Contrast-Enhanced MRI in the Evaluation of Intrapelvic Recurrence of Gynecological Malignant Tumor |
title_short | Role of Diffusion Weighted Imaging and Contrast-Enhanced MRI in the Evaluation of Intrapelvic Recurrence of Gynecological Malignant Tumor |
title_sort | role of diffusion weighted imaging and contrast-enhanced mri in the evaluation of intrapelvic recurrence of gynecological malignant tumor |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4309401/ https://www.ncbi.nlm.nih.gov/pubmed/25629156 http://dx.doi.org/10.1371/journal.pone.0117411 |
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