Stefania Rizzo1, Marco Femia2, Davide Radice3, Maria Del Grande4, Dorella Franchi5, Daniela Origgi6, Valentina Buscarino2, Alberto Mauro7, Massimo Bellomi8,9. 1. Department of Radiology, European Institute of Oncology, via Ripamonti 435, 20141, Milan, Italy. stefania.rizzo@ieo.it. 2. Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono 7, 20122, Milan, Italy. 3. Department of Epidemiology and Biostatistics, European Institute of Oncology, Via Ramusio 1, 20141, Milan, Italy. 4. Oncology Institute of Southern Switzerland, San Giovanni Hospital, 6500, Bellinzona, Switzerland. 5. Department of Gynecologic Oncology, European Institute of Oncology, via Ripamonti 435, 20141, Milan, Italy. 6. Medical Physics, European Institute of Oncology, via Ripamonti 435, 20141, Milan, Italy. 7. GE Healthcare Italia SpA, Via Galeno 36, 20126, Milan, Italy. 8. Department of Radiology, European Institute of Oncology, via Ripamonti 435, 20141, Milan, Italy. 9. Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, via Festa del Perdono 7, 20122, Milan, Italy.
Abstract
OBJECTIVES: Assessment of deep (>50%) myometrial invasion by dual-energy CT (DECT) and Trans-Vaginal US (TVUS) in patients with endometrial cancer. METHODS: We retrospectively enrolled patients with endometrial cancer who underwent DECT and TVUS for pre-surgical staging. Three sets of images were evaluated: 70 keV (routine CT images), 50 keV, and iodine-water reconstructions. The gold standard was pathology after surgery. The agreement between the different imaging modalities and the gold standard was estimated. Sensitivity, specificity and accuracy for each imaging modality were evaluated with 95% confidence intervals (CI). RESULTS: Thirty-nine patients were included. Median time from CT and TVUS to surgery was 23 and 18 days, respectively. The best agreement between evaluation of myometrial infiltration and the gold standard was 0.88 (0.72, 1.00) for the 50 keV images; the worst agreement was 0.43 (0.00, 0.88) for the 70 keV images. CT iodine reconstructions and US agreement were comparable. Specificity, sensitivity and accuracy were 0.91, 1.00, 0.94; 0.57, 0.86, 0.71; 0.82, 1.00, 0.87; 0.91, 0.77, 0.86 for 50 keV, 70 keV, iodine reconstructions and ultrasound, respectively. CONCLUSIONS: DECT is a promising tool for assessment of myometrial invasion in endometrial cancer patients, with a special focus on 50 keV images.
OBJECTIVES: Assessment of deep (>50%) myometrial invasion by dual-energy CT (DECT) and Trans-Vaginal US (TVUS) in patients with endometrial cancer. METHODS: We retrospectively enrolled patients with endometrial cancer who underwent DECT and TVUS for pre-surgical staging. Three sets of images were evaluated: 70 keV (routine CT images), 50 keV, and iodine-water reconstructions. The gold standard was pathology after surgery. The agreement between the different imaging modalities and the gold standard was estimated. Sensitivity, specificity and accuracy for each imaging modality were evaluated with 95% confidence intervals (CI). RESULTS: Thirty-nine patients were included. Median time from CT and TVUS to surgery was 23 and 18 days, respectively. The best agreement between evaluation of myometrial infiltration and the gold standard was 0.88 (0.72, 1.00) for the 50 keV images; the worst agreement was 0.43 (0.00, 0.88) for the 70 keV images. CT iodine reconstructions and US agreement were comparable. Specificity, sensitivity and accuracy were 0.91, 1.00, 0.94; 0.57, 0.86, 0.71; 0.82, 1.00, 0.87; 0.91, 0.77, 0.86 for 50 keV, 70 keV, iodine reconstructions and ultrasound, respectively. CONCLUSIONS: DECT is a promising tool for assessment of myometrial invasion in endometrial cancerpatients, with a special focus on 50 keV images.
Entities:
Keywords:
Dual Energy CT; Endometrial cancer; Imaging; Myometrial invasion; Ultrasound
Authors: Y Yamashita; H Mizutani; M Torashima; M Takahashi; K Miyazaki; H Okamura; H Ushijima; H Ohtake; T Tokunaga Journal: AJR Am J Roentgenol Date: 1993-09 Impact factor: 3.959
Authors: N Colombo; C Creutzberg; F Amant; T Bosse; A González-Martín; J Ledermann; C Marth; R Nout; D Querleu; M R Mirza; C Sessa Journal: Ann Oncol Date: 2015-12-02 Impact factor: 32.976