Jung Jae Park1, Chan Kyo Kim, Sung Yoon Park, Byung Kwan Park. 1. From the Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul 135-710, Republic of Korea.
Abstract
PURPOSE: To retrospectively investigate the value of fused T2-weighted and high-b-value diffusion-weighted imaging with background body signal suppression (DWIBS) at 3 T to evaluate parametrial invasion in cervical cancer. MATERIALS AND METHODS: In this institutional review board-approved study, 152 consecutive patients with biopsy-proven cervical cancer who underwent radical hysterectomies also underwent pretreatment magnetic resonance imaging (T2-weighted imaging and DWIBS) at 3 T. Two radiologists independently evaluated the presence of parametrial invasion at T2-weighted imaging, fused T2-weighted imaging and high-b-value DWIBS (ie, fused T2-weighted DWIBS), and combined T2-weighted imaging and fused T2-weighted DWIBS, and the results were compared with histopathologic findings. RESULTS: Parametrial invasion was identified by pathologic analysis in 37 of 152 patients (24.3%). For association with parametrial invasion, the specificity and accuracy of fused T2-weighted DWIBS (97.4% and 90.1%, respectively, for reader 1; 95.7% and 89.5%, respectively, for reader 2) and combined T2-weighted imaging and fused T2-weighted DWIBS (99.1% and 93.4%, respectively, for reader 1; 96.5% and 92.8%, respectively, for reader 2) were significantly better than those of T2-weighted imaging alone (88.7% and 85.5%, respectively, for reader 1; 85.2% and 83.6%, respectively, for reader 2) (all P < .05). The respective sensitivity of T2-weighted imaging, fused T2-weighted DWIBS, and combined T2-weighted imaging and fused T2-weighted DWIBS was 75.7%, 67.6%, and 75.7% for reader 1 and 78.4%, 70.3%, and 81.1% for reader 2, and did not show significant differences (P value, ≤.375 to >.999). The respective area under the curve for association with parametrial invasion of T2-weighted imaging, fused T2-weighted DWIBS, and combined T2-weighted imaging and fused T2-weighted DWIBS was 0.912, 0.951, and 0.976 for reader 1 and 0.890, 0.932, and 0.968 for reader 2 (P < .05). Interreader agreements were excellent (κ = 0.89, 0.9, and 0.86 for T2-weighted imaging, fused T2-weighted DWIBS, and combined T2-weighted imaging and fused T2-weighted DWIBS, respectively). CONCLUSION: Fusion of high-b-value DWIBS with T2-weighted imaging can improve the diagnostic performance in association with parametrial invasion in cervical cancer compared with T2-weighted imaging alone.
PURPOSE: To retrospectively investigate the value of fused T2-weighted and high-b-value diffusion-weighted imaging with background body signal suppression (DWIBS) at 3 T to evaluate parametrial invasion in cervical cancer. MATERIALS AND METHODS: In this institutional review board-approved study, 152 consecutive patients with biopsy-proven cervical cancer who underwent radical hysterectomies also underwent pretreatment magnetic resonance imaging (T2-weighted imaging and DWIBS) at 3 T. Two radiologists independently evaluated the presence of parametrial invasion at T2-weighted imaging, fused T2-weighted imaging and high-b-value DWIBS (ie, fused T2-weighted DWIBS), and combined T2-weighted imaging and fused T2-weighted DWIBS, and the results were compared with histopathologic findings. RESULTS: Parametrial invasion was identified by pathologic analysis in 37 of 152 patients (24.3%). For association with parametrial invasion, the specificity and accuracy of fused T2-weighted DWIBS (97.4% and 90.1%, respectively, for reader 1; 95.7% and 89.5%, respectively, for reader 2) and combined T2-weighted imaging and fused T2-weighted DWIBS (99.1% and 93.4%, respectively, for reader 1; 96.5% and 92.8%, respectively, for reader 2) were significantly better than those of T2-weighted imaging alone (88.7% and 85.5%, respectively, for reader 1; 85.2% and 83.6%, respectively, for reader 2) (all P < .05). The respective sensitivity of T2-weighted imaging, fused T2-weighted DWIBS, and combined T2-weighted imaging and fused T2-weighted DWIBS was 75.7%, 67.6%, and 75.7% for reader 1 and 78.4%, 70.3%, and 81.1% for reader 2, and did not show significant differences (P value, ≤.375 to >.999). The respective area under the curve for association with parametrial invasion of T2-weighted imaging, fused T2-weighted DWIBS, and combined T2-weighted imaging and fused T2-weighted DWIBS was 0.912, 0.951, and 0.976 for reader 1 and 0.890, 0.932, and 0.968 for reader 2 (P < .05). Interreader agreements were excellent (κ = 0.89, 0.9, and 0.86 for T2-weighted imaging, fused T2-weighted DWIBS, and combined T2-weighted imaging and fused T2-weighted DWIBS, respectively). CONCLUSION: Fusion of high-b-value DWIBS with T2-weighted imaging can improve the diagnostic performance in association with parametrial invasion in cervical cancer compared with T2-weighted imaging alone.
Authors: Sebastian Bickelhaupt; Jana Tesdorff; Frederik Bernd Laun; Tristan Anselm Kuder; Wolfgang Lederer; Susanne Teiner; Klaus Maier-Hein; Heidi Daniel; Anne Stieber; Stefan Delorme; Heinz-Peter Schlemmer Journal: Eur Radiol Date: 2016-05-18 Impact factor: 5.315
Authors: Noemi Maria Giovanna Ognibene; Massimo Basile; Marco Di Maurizio; Giuseppe Petrillo; Claudio De Filippi Journal: Radiol Med Date: 2016-02-02 Impact factor: 3.469