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Presentations text content in Comparison of Preoperative Magnetic Resonance Imaging Results with Postoperative Pathologic Results
Slide1
Comparison of Preoperative Magnetic Resonance Imaging Results with Postoperative Pathologic Results in Early Stage Uterine Cervical Cancer
Zehra Nihal Dolgun, Ahmet Salih
Altintas
,
Cihan
Inan
, Petek
Balkanli
Trakya University
,
Faculty
of
Medicine
,
Department of Obstetrics and Gynecology,
Edirne
Slide2
Uterine cervical
cancer is the second most common cancer in women after breast cancer. Despite routine follow-up protocols, it is still the most fatal gynecologic cancer worldwide.American Cancer
Society
: Cancer Facts & Figures. Atlanta, Georgia, 2014Pecorelli S. Int J Gynaecol Obstet, 2009
The International Federation of Gynecology and Obstetrics (FIGO) describes cervical cancer staging clinically. Although imaging modalities may apply for detection of pelvic wall and
parametrium
invasion, they do not change the clinical staging .
Slide3
FIGO
Cervical Cancer
Staging
Slide4
Preoperative evaluations should include the level of tumor extension towards external os, the prediction of tumor size and tumoral stromal invasion to plan the appropriate treatment
There are some limitations in FIGO clinical staging. Parametrial or sidewall invasions, metastases to pelvic and
paraaortic lymph nodes can be difficult to determine accurately.Lee SI, et al. J Nucl
Med
, 2015 For this reason, some additional imaging modalities such as abdominal/pelvic computed tomography (CT), positron emission tomography (PET), pelvic magnetic resonance imaging (MRI) are used in preoperative period.
Slide6
Aim
To compare the preoperative MRI findings of early stage cervical cancer patients with their postoperative hystopathologic results.
Material
and MethodsThis is a retrospective study of 30 women who were diagnosed, operated
and
had
preoperative
MRI
examinations
in
our
institution
.
Slide7
Medical charts of the patients were examined. Demographic data,
clinical FIGO staging of tumors, MRI examination results and postoperative pathologic results were recorded.Material
and
MethodsMR images were analyzed for presence of cervical tumor, tumor stage, tumor size in three dimensions, invasion depth within cervix, the presence of parametrial and vaginal infiltration,
lymph
node
involvement
,
vesical
and
rectal
invasion
.
Slide8
Material and Methods
The correlation of preoperative clinical FIGO and MRI stagings with postoperative histological staging, preoperative MRI examination accordances with pathological results and preoperative–postoperative
histopatologic
consistencies were evaluated.
Slide9
Results
Pathological
staging
(n)Clinically correct staging (n)Correct staging by MRI (n)1a212
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DownloadNote - The PPT/PDF document "Comparison of Preoperative Magnetic Reso..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Presentations text content in Comparison of Preoperative Magnetic Resonance Imaging Results with Postoperative Pathologic Results
Comparison of Preoperative Magnetic Resonance Imaging Results with Postoperative Pathologic Results in Early Stage Uterine Cervical Cancer
Zehra Nihal Dolgun, Ahmet Salih
Altintas
,
Cihan
Inan
, Petek
Balkanli
Trakya University
,
Faculty
of
Medicine
,
Department of Obstetrics and Gynecology,
Edirne
Slide2Uterine cervical
cancer is the second most common cancer in women after breast cancer. Despite routine follow-up protocols, it is still the most fatal gynecologic cancer worldwide.American Cancer
Society
: Cancer Facts & Figures. Atlanta, Georgia, 2014Pecorelli S. Int J Gynaecol Obstet, 2009
The International Federation of Gynecology and Obstetrics (FIGO) describes cervical cancer staging clinically. Although imaging modalities may apply for detection of pelvic wall and
parametrium
invasion, they do not change the clinical staging .
Slide3FIGO
Cervical Cancer
Staging
Slide4Preoperative evaluations should include the level of tumor extension towards external os, the prediction of tumor size and tumoral stromal invasion to plan the appropriate treatment
.Pecorelli S, et al. Int J Gynaecol
Obstet
, 2009Pelvic examination, cervical biopsy and optical imaging (colposcopy, cystoscopy, intravenous
pyelogram
or
proctoscopy
,
e.g
.)
are
generally
used
before
treatment
.
Slide5There are some limitations in FIGO clinical staging. Parametrial or sidewall invasions, metastases to pelvic and
paraaortic lymph nodes can be difficult to determine accurately.Lee SI, et al. J Nucl
Med
, 2015 For this reason, some additional imaging modalities such as abdominal/pelvic computed tomography (CT), positron emission tomography (PET), pelvic magnetic resonance imaging (MRI) are used in preoperative period.
Slide6Aim
To compare the preoperative MRI findings of early stage cervical cancer patients with their postoperative hystopathologic results.
Material
and MethodsThis is a retrospective study of 30 women who were diagnosed, operated
and
had
preoperative
MRI
examinations
in
our
institution
.
Slide7Medical charts of the patients were examined. Demographic data,
clinical FIGO staging of tumors, MRI examination results and postoperative pathologic results were recorded.Material
and
MethodsMR images were analyzed for presence of cervical tumor, tumor stage, tumor size in three dimensions, invasion depth within cervix, the presence of parametrial and vaginal infiltration,
lymph
node
involvement
,
vesical
and
rectal
invasion
.
Slide8Material and Methods
The correlation of preoperative clinical FIGO and MRI stagings with postoperative histological staging, preoperative MRI examination accordances with pathological results and preoperative–postoperative
histopatologic
consistencies were evaluated.
Slide9Results
Pathological
staging
(n)Clinically correct staging (n)Correct staging by MRI (n)1a212
1b1
9
6
6
1b2
3
0
1
2a
5
0
4
2b
11
0
7
TOTAL
30
7
20
Correct
staging
of MRI
and
clinical
evaluation
according
to
pathological
staging
Slide10Results
Histopathological
StagingTOTAL 1a
1b1
1b2
2a
2b
Clinically
FIGO
Staging
(n)
1a
1
3
0
0
0
4
1b1
1
6
335
18
1b2
0061072a0000002b000101 MRI Staging (n)1a2200041b10610291b20010122a0114172b000178 TOTAL29351130
Comparison
of
different
stagings
Slide11Results
MRI Stages
Sensitivity
Specificity
PPVNPV1a10.930.50
0.92
1b1
0.66
0.84
0.33
0.87
1b2
0.33
0.96
0.50
0.93
2a
0.96
0.89
0.57
0.95
2b
0.63
0.95
0.870.85
Staging
accuracy of Magnetic resonance imaging
Slide12Results
Tumor size <4cm
17
patients
MRI 8 patients Tumor size ≥ 4cm 13 patients
MRI 9
patients
MRI
sensitivity
in
correct
tumor
size
detection
0.68
Slide13Results
MRI
Pathology Tumoral characteristicsPresent on MRI
Present
in MRI
and
Pathology
Present
Absent
Cervical
ring
invasion
(n)
17
13
20
10
Parametrium invasion (n)87
11
19
Pelvic lymph node invasion (n)33921 Paraaortic lymph node invasion (n)00030Magnetic resonance imaging and pathology findings of tumor invasion
Slide14Conclusions
MRI staged 20 out of 30 patients (66.6%) correctly Only 7
patients
(23.3%)
were staged correctly with clinical examination. MRI overstaged 10% and understaged 23% of the cases.MRI staging is superior
to
clinical
staging
even
in
early
stages
of
cervical
cancer
.
Slide15Thank
you…