Preoperative MR staging of cervical carcinoma: are oblique and contrast-enhanced sequences necessary?
BACKGROUND: As the choice of treatment in patients with cervical carcinoma depends on cancer stage at diagnosis, accurate staging is essential. PURPOSE: To compare three different combinations of magnetic resonance (MR) sequences for preoperative staging. MATERIAL AND METHODS: Fifty-seven consecutiv...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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SAGE Publications
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5122173/ https://www.ncbi.nlm.nih.gov/pubmed/27900204 http://dx.doi.org/10.1177/2058460116679460 |
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author | Fridsten, Susanne Hellström, Ann-Cathrin Hellman, Kristina Sundin, Anders Söderén, Boel Blomqvist, Lennart |
author_facet | Fridsten, Susanne Hellström, Ann-Cathrin Hellman, Kristina Sundin, Anders Söderén, Boel Blomqvist, Lennart |
author_sort | Fridsten, Susanne |
collection | PubMed |
description | BACKGROUND: As the choice of treatment in patients with cervical carcinoma depends on cancer stage at diagnosis, accurate staging is essential. PURPOSE: To compare three different combinations of magnetic resonance (MR) sequences for preoperative staging. MATERIAL AND METHODS: Fifty-seven consecutive patients with biopsy proven cervical carcinoma underwent MR imaging (MRI) staging followed by primary surgical treatment. Thirty-two of 57 patients had had a cone biopsy prior to MRI. Three MR pulse sequence combinations were retrospectively reviewed by two experienced radiologists. The first imaging protocol consisted of pre-contrast sagittal and transverse images (protocol A), the second protocol included additionally oblique high-resolution T2-weighted (T2W) MR images of the cervix (protocol A+B), and the third included also contrast-enhanced sequences (protocol A+B+C). The imaging findings in the three steps (A, A+B, A+B+C) were recorded. The TNM stage was used for comparison between preoperative imaging and histopathology. Histopathology, together with surgical findings, served as gold standard. RESULTS: In 4/57 (7%) patients, the MR assessment of tumor stage (mrT) was altered when oblique sequences were added to the standard two plane imaging protocol (A+B). The mrT stage was altered in 1/57 (2%) patient when contrast-enhanced sequences were added to standard and oblique sequences (protocol A+B+C). The correlation between visible tumor on MRI and presence of tumor in the resected specimen did not change by adding oblique or contrast-enhanced images. CONCLUSION: It is not necessary to perform oblique and contrast-enhanced sequences in small cervical carcinomas, i.e. without parametrial invasion. To avoid erroneous interpretation, information on previous cone biopsy is essential. |
format | Online Article Text |
id | pubmed-5122173 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-51221732016-11-29 Preoperative MR staging of cervical carcinoma: are oblique and contrast-enhanced sequences necessary? Fridsten, Susanne Hellström, Ann-Cathrin Hellman, Kristina Sundin, Anders Söderén, Boel Blomqvist, Lennart Acta Radiol Open Research BACKGROUND: As the choice of treatment in patients with cervical carcinoma depends on cancer stage at diagnosis, accurate staging is essential. PURPOSE: To compare three different combinations of magnetic resonance (MR) sequences for preoperative staging. MATERIAL AND METHODS: Fifty-seven consecutive patients with biopsy proven cervical carcinoma underwent MR imaging (MRI) staging followed by primary surgical treatment. Thirty-two of 57 patients had had a cone biopsy prior to MRI. Three MR pulse sequence combinations were retrospectively reviewed by two experienced radiologists. The first imaging protocol consisted of pre-contrast sagittal and transverse images (protocol A), the second protocol included additionally oblique high-resolution T2-weighted (T2W) MR images of the cervix (protocol A+B), and the third included also contrast-enhanced sequences (protocol A+B+C). The imaging findings in the three steps (A, A+B, A+B+C) were recorded. The TNM stage was used for comparison between preoperative imaging and histopathology. Histopathology, together with surgical findings, served as gold standard. RESULTS: In 4/57 (7%) patients, the MR assessment of tumor stage (mrT) was altered when oblique sequences were added to the standard two plane imaging protocol (A+B). The mrT stage was altered in 1/57 (2%) patient when contrast-enhanced sequences were added to standard and oblique sequences (protocol A+B+C). The correlation between visible tumor on MRI and presence of tumor in the resected specimen did not change by adding oblique or contrast-enhanced images. CONCLUSION: It is not necessary to perform oblique and contrast-enhanced sequences in small cervical carcinomas, i.e. without parametrial invasion. To avoid erroneous interpretation, information on previous cone biopsy is essential. SAGE Publications 2016-11-22 /pmc/articles/PMC5122173/ /pubmed/27900204 http://dx.doi.org/10.1177/2058460116679460 Text en © The Foundation Acta Radiologica 2016 http://creativecommons.org/licenses/by-nc/3.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License (http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page(https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Research Fridsten, Susanne Hellström, Ann-Cathrin Hellman, Kristina Sundin, Anders Söderén, Boel Blomqvist, Lennart Preoperative MR staging of cervical carcinoma: are oblique and contrast-enhanced sequences necessary? |
title | Preoperative MR staging of cervical carcinoma: are oblique and contrast-enhanced sequences necessary? |
title_full | Preoperative MR staging of cervical carcinoma: are oblique and contrast-enhanced sequences necessary? |
title_fullStr | Preoperative MR staging of cervical carcinoma: are oblique and contrast-enhanced sequences necessary? |
title_full_unstemmed | Preoperative MR staging of cervical carcinoma: are oblique and contrast-enhanced sequences necessary? |
title_short | Preoperative MR staging of cervical carcinoma: are oblique and contrast-enhanced sequences necessary? |
title_sort | preoperative mr staging of cervical carcinoma: are oblique and contrast-enhanced sequences necessary? |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5122173/ https://www.ncbi.nlm.nih.gov/pubmed/27900204 http://dx.doi.org/10.1177/2058460116679460 |
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