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Early-stage cervical cancer: Tumor delineation by magnetic resonance imaging and ultrasound - A European multicenter trial

Epstein, Elisabeth ; Testa, Antonia ; Gaurilcikas, Adrius ; Di Legge, Alessia ; Ameye, Liveke ; Atstupenaite, Vaida ; Valentini, Anna Lia ; Gui, Benedetta ; Wallengren, Nils-Olof LU and Pudaric, Sonja LU , et al. (2013) In Gynecologic Oncology 128(3). p.449-453
Abstract
Objective. To compare the diagnostic accuracy of ultrasound (US) and magnetic resonance imaging (MRI) in the preoperative assessment of early-stage cervical cancer using pathologic findings as the reference standard. Patients and methods. Prospective multi-center trial enrolling 209 consecutive women with early-stage cervical cancer (FIGO IA2-IIA) scheduled for surgery. The following parameters were assessed on US and MRI and compared to pathology: remaining tumor, size, tumor stromal invasion <2/3 (superficial) or >= 2/3 (deep), and parametrial invasion. Results. Complete data were available for 182 patients. The agreement between US and pathology was excellent for detecting tumors, correctly classifying bulky tumors (>4 cm), and... (More)
Objective. To compare the diagnostic accuracy of ultrasound (US) and magnetic resonance imaging (MRI) in the preoperative assessment of early-stage cervical cancer using pathologic findings as the reference standard. Patients and methods. Prospective multi-center trial enrolling 209 consecutive women with early-stage cervical cancer (FIGO IA2-IIA) scheduled for surgery. The following parameters were assessed on US and MRI and compared to pathology: remaining tumor, size, tumor stromal invasion <2/3 (superficial) or >= 2/3 (deep), and parametrial invasion. Results. Complete data were available for 182 patients. The agreement between US and pathology was excellent for detecting tumors, correctly classifying bulky tumors (>4 cm), and detecting deep stromal invasion (kappa values 0.84, 0.82, and 0.81 respectively); and good for classifying small tumors (<2 cm) and detecting parametrial invasion (kappa values 0.78 and 0.75, respectively). The agreement between MRI and histology was good for classifying tumors as <2 cm, or >4 cm, and detecting deep stromal invasion (kappa values 0.71, 0.76, and 0.77, respectively). It was Moderately accurate in tumor detection, and in assessing parametrial invasion (kappa values 0.52 and 0.45, respectively). The agreement between histology and US was significantly better in assessing residual tumor (p<0.001) and parametrial invasion (p<0.001) than the results obtained by MRI. Imaging methods were not significantly influenced by previous cone biopsy. Conclusion. US and MRI are highly accurate for the preoperative assessment of women with early-stage cervical cancer, although US may be more accurate in detecting residual tumors and assessing parametrial invasion. (C) 2012 Elsevier Inc. All rights reserved. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Magnetic resonance tomography, Ultrasound, Cervical cancer, Imaging, Staging
in
Gynecologic Oncology
volume
128
issue
3
pages
449 - 453
publisher
Academic Press
external identifiers
  • wos:000315320900008
  • scopus:84873714585
  • pmid:23022593
ISSN
1095-6859
DOI
10.1016/j.ygyno.2012.09.025
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Pathology, (Lund) (013030000), Department of Obstetrics and Gynaecology (Lund) (013018000), Diagnostic Radiology, (Lund) (013038000), Faculty of Medicine (000022000)
id
3359901c-feb2-4e33-b974-5157781bb9bd (old id 3670031)
date added to LUP
2016-04-01 10:34:50
date last changed
2022-09-15 12:35:42
@article{3359901c-feb2-4e33-b974-5157781bb9bd,
  abstract     = {{Objective. To compare the diagnostic accuracy of ultrasound (US) and magnetic resonance imaging (MRI) in the preoperative assessment of early-stage cervical cancer using pathologic findings as the reference standard. Patients and methods. Prospective multi-center trial enrolling 209 consecutive women with early-stage cervical cancer (FIGO IA2-IIA) scheduled for surgery. The following parameters were assessed on US and MRI and compared to pathology: remaining tumor, size, tumor stromal invasion &lt;2/3 (superficial) or &gt;= 2/3 (deep), and parametrial invasion. Results. Complete data were available for 182 patients. The agreement between US and pathology was excellent for detecting tumors, correctly classifying bulky tumors (&gt;4 cm), and detecting deep stromal invasion (kappa values 0.84, 0.82, and 0.81 respectively); and good for classifying small tumors (&lt;2 cm) and detecting parametrial invasion (kappa values 0.78 and 0.75, respectively). The agreement between MRI and histology was good for classifying tumors as &lt;2 cm, or &gt;4 cm, and detecting deep stromal invasion (kappa values 0.71, 0.76, and 0.77, respectively). It was Moderately accurate in tumor detection, and in assessing parametrial invasion (kappa values 0.52 and 0.45, respectively). The agreement between histology and US was significantly better in assessing residual tumor (p&lt;0.001) and parametrial invasion (p&lt;0.001) than the results obtained by MRI. Imaging methods were not significantly influenced by previous cone biopsy. Conclusion. US and MRI are highly accurate for the preoperative assessment of women with early-stage cervical cancer, although US may be more accurate in detecting residual tumors and assessing parametrial invasion. (C) 2012 Elsevier Inc. All rights reserved.}},
  author       = {{Epstein, Elisabeth and Testa, Antonia and Gaurilcikas, Adrius and Di Legge, Alessia and Ameye, Liveke and Atstupenaite, Vaida and Valentini, Anna Lia and Gui, Benedetta and Wallengren, Nils-Olof and Pudaric, Sonja and Cizauskas, Arvydas and Måsbäck, Anna and Zannoni, Gian Franco and Kannisto, Päivi and Zikan, Michal and Pinkavova, Ivana and Burgetova, Andrea and Dundr, Pavel and Nemejcova, Kristyna and Cibula, David and Fischerova, Daniela}},
  issn         = {{1095-6859}},
  keywords     = {{Magnetic resonance tomography; Ultrasound; Cervical cancer; Imaging; Staging}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{449--453}},
  publisher    = {{Academic Press}},
  series       = {{Gynecologic Oncology}},
  title        = {{Early-stage cervical cancer: Tumor delineation by magnetic resonance imaging and ultrasound - A European multicenter trial}},
  url          = {{http://dx.doi.org/10.1016/j.ygyno.2012.09.025}},
  doi          = {{10.1016/j.ygyno.2012.09.025}},
  volume       = {{128}},
  year         = {{2013}},
}