OBJECTIVE: To perform a literature review assessing role of MRI in predicting origin of indeterminate uterocervical carcinomas with emphasis on sequences and imaging parameters. METHODS: Electronic literature search of PubMed was performed from its inception until May 2020 and PICO model used for study selection; population was female patients with known/clinical suspicion of uterocervical cancer, intervention was MRI, comparison was by histopathology and outcome was differentiation between primary endometrial and cervical cancers. RESULTS: Eight out of nine reviewed articles reinforced role of MRI in uterocervical primary determination. T2 and Dynamic contrast were the most popular sequences determining tumor location, morphology, enhancement, and invasion patterns. Role of DWI and MR spectroscopy has been evaluated by even fewer studies with significant differences found in both apparent diffusion coefficient values and metabolite spectra. The four studies eligible for meta-analysis showed a pooled sensitivity of 88.4% (95% confidence interval 70.6 to 96.1%) and a pooled specificity of 39.5% (95% confidence interval 4.2 to 90.6%). CONCLUSIONS: MRI plays a pivotal role in uterocervical primary determination with both conventional and newer sequences assessing important morphometric and functional parameters. Socioeconomic impact of both primaries, different management guidelines and paucity of existing studies warrants further research. Prospective multicenter trials will help bridge this gap. Meanwhile, individual patient database meta-analysis can help corroborate existing data. ADVANCES IN KNOWLEDGE: MRI with its classical and functional sequences helps in differentiation of the uterine 'cancer gray zone' which is imperative as both primary endometrial and cervical tumors have different management protocols.
OBJECTIVE: To perform a literature review assessing role of MRI in predicting origin of indeterminate uterocervical carcinomas with emphasis on sequences and imaging parameters. METHODS: Electronic literature search of PubMed was performed from its inception until May 2020 and PICO model used for study selection; population was female patients with known/clinical suspicion of uterocervical cancer, intervention was MRI, comparison was by histopathology and outcome was differentiation between primary endometrial and cervical cancers. RESULTS: Eight out of nine reviewed articles reinforced role of MRI in uterocervical primary determination. T2 and Dynamic contrast were the most popular sequences determining tumor location, morphology, enhancement, and invasion patterns. Role of DWI and MR spectroscopy has been evaluated by even fewer studies with significant differences found in both apparent diffusion coefficient values and metabolite spectra. The four studies eligible for meta-analysis showed a pooled sensitivity of 88.4% (95% confidence interval 70.6 to 96.1%) and a pooled specificity of 39.5% (95% confidence interval 4.2 to 90.6%). CONCLUSIONS: MRI plays a pivotal role in uterocervical primary determination with both conventional and newer sequences assessing important morphometric and functional parameters. Socioeconomic impact of both primaries, different management guidelines and paucity of existing studies warrants further research. Prospective multicenter trials will help bridge this gap. Meanwhile, individual patient database meta-analysis can help corroborate existing data. ADVANCES IN KNOWLEDGE: MRI with its classical and functional sequences helps in differentiation of the uterine 'cancer gray zone' which is imperative as both primary endometrial and cervical tumors have different management protocols.
Authors: William T C Yuh; Nina A Mayr; David Jarjoura; Dee Wu; John C Grecula; Simon S Lo; Susan M Edwards; Vincent A Magnotta; Steffen Sammet; Hualin Zhang; Joseph F Montebello; Jeffrey Fowler; Michael V Knopp; Jian Z Wang Journal: Invest Radiol Date: 2009-06 Impact factor: 6.016
Authors: Masoom A Haider; Michael Patlas; Kartik Jhaveri; William Chapman; Anthony Fyles; Barry Rosen Journal: Can Assoc Radiol J Date: 2006-02 Impact factor: 2.248
Authors: Jesus Paul Carvalho; Publio Viana; Cristina Anton; Giovanni Favero; Alexandre Silva E Silva; Edmund Chada Baracat; Filomena Marino Carvalho Journal: Rare Tumors Date: 2012-03-20