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European Radiology
Published in: European Radiology 4/2016

Open Access 01-04-2016 | Magnetic Resonance

Comparison of optimised endovaginal vs external array coil T2-weighted and diffusion-weighted imaging techniques for detecting suspected early stage (IA/IB1) uterine cervical cancer

Authors: Kate Downey, Ayoma D. Attygalle, Veronica A. Morgan, Sharon L. Giles, A. MacDonald, M. Davis, Thomas E. J. Ind, John H. Shepherd, Nandita M. deSouza

Published in: European Radiology | Issue 4/2016

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Abstract

Objective

To compare sensitivity and specificity of endovaginal versus external-array coil T2-W and T2-W + DWI for detecting and staging small cervical tumours.

Methods

Optimised endovaginal and external array coil MRI at 3.0-T was done prospectively in 48 consecutive patients with stage Ia/Ib1 cervical cancer. Sensitivity/specificity for detecting tumour and parametrial extension against histopathology for a reading radiologist were determined on coronal T2-W and T2W + DW images. An independent radiologist also scored T2-W images without and with addition of DWI for the external-array and endovaginal coils on separate occasions >2 weeks apart. Cohen’s kappa assessed inter- and intra-observer agreement.

Results

Median tumour volume in 19/38 cases positive on subsequent histology was 1.75 cm3. Sensitivity, specificity, PPV, NPV were: reading radiologist 91.3 %, 89.5 %, 91.3 %, 89.5 %, respectively; independent radiologist T2-W 82.6 %, 73.7 %, 79.1 %, 77.8 % for endovaginal, 73.9 %, 89.5 %, 89.5 %, 73.9 % for external-array coil. Adding DWI improved sensitivity and specificity of endovaginal imaging (78.2 %, 89.5 %); adding DWI to external-array imaging improved specificity (94.7 %) but reduced sensitivity (66.7 %). Inter- and intra-observer agreement on T2-W + DWI was good (kappa = 0.67 and 0.62, respectively).

Conclusion

Endovaginal coil T2-W MRI is more sensitive than external-array coil for detecting tumours <2 cm3; adding DWI improves specificity of endovaginal imaging but reduces sensitivity of external-array imaging.

Key Points

• Endovaginal more accurate than external-array T2-W MRI for detecting small cervical cancers.
• Addition of DWI improves sensitivity and specificity of endovaginal T2-W imaging.
• Addition of DWI substantially reduces sensitivity of external-array T2-W imaging.
Literature
1.
Abu-Rustum NR, Neubauer N, Sonoda Y, Park KJ, Gemignani M, Alektiar KM, Tew W, Leitao MM, Chi DS, Barakat RR (2008) Surgical and pathologic outcomes of fertility-sparing radical abdominal trachelectomy for FIGO stage IB1 cervical cancer. Gynecol Oncol 111:261–264CrossRefPubMed
2.
Gien LT, Covens A (2010) Fertility-sparing options for early stage cervical cancer. Gynecol Oncol 117:350–357CrossRefPubMed
3.
Shepherd JH, Spencer C, Herod J, Ind TE (2006) Radical vaginal trachelectomy as a fertility-sparing procedure in women with early-stage cervical cancer-cumulative pregnancy rate in a series of 123 women. BJOG 113:719–724CrossRefPubMed
4.
Bipat S, Van Den Berg RA, Van Der Velden J, Stoker J, Spijkerboer AM (2011) The role of magnetic resonance imaging in determining the proximal extension of early stage cervical cancer to the internal os. Eur J Radiol 78:60–64CrossRefPubMed
5.
Sheu MH, Chang CY, Wang JH, Yen MS (2001) Preoperative staging of cervical carcinoma with MR imaging: a reappraisal of diagnostic accuracy and pitfalls. Eur Radiol 11:1828–1833CrossRefPubMed
6.
Vargas HA, Akin O, Zheng J, Moskowitz C, Soslow R, Abu-Rustum N, Barakat RR, Hricak H (2011) The value of MR imaging when the site of uterine cancer origin is uncertain. Radiology 258:785–792CrossRefPubMed
7.
Peppercorn PD, Jeyarajah AR, Woolas R, Shepherd JH, Oram DH, Jacobs IJ, Armstrong P, Lowe D, Reznek RH (1999) Role of MR imaging in the selection of patients with early cervical carcinoma for fertility-preserving surgery: initial experience. Radiology 212:395–399CrossRefPubMed
8.
Hricak H, Gatsonis C, Coakley FV, Snyder B, Reinhold C, Schwartz LH, Woodward PJ, Pannu HK, Amendola M, Mitchell DG (2007) Early invasive cervical cancer: CT and MR imaging in preoperative evaluation - ACRIN/GOG comparative study of diagnostic performance and interobserver variability. Radiology 245:491–498CrossRefPubMed
9.
Sahdev A, Sohaib SA, Wenaden AE, Shepherd JH, Reznek RH (2007) The performance of magnetic resonance imaging in early cervical carcinoma: a long-term experience. Int J Gynecol Cancer 17:629–636CrossRefPubMed
10.
deSouza NM, Dina R, Mcindoe GA, Soutter WP (2006) Cervical cancer: value of an endovaginal coil magnetic resonance imaging technique in detecting small volume disease and assessing parametrial extension. Gynecol Oncol 102:80–85CrossRefPubMed
11.
deSouza NM, Scoones D, Krausz T, Gilderdale DJ, Soutter WP (1996) High-resolution MR imaging of stage I cervical neoplasia with a dedicated transvaginal coil: MR features and correlation of imaging and pathologic findings. AJR Am J Roentgenol 166:553–559CrossRefPubMed
12.
deSouza NM, Whittle M, Williams AD, Sohail M, Krausz T, Gilderdale DJ, Mcindoe GA, Soutter WP (2000) Magnetic resonance imaging of the primary site in stage I cervical carcinoma: a comparison of endovaginal coil with external phased array coil techniques at 0.5T. J Magn Reson Imaging 12:1020–1026CrossRefPubMed
13.
Soutter WP, Hanoch J, D'arcy T, Dina R, Mcindoe GA, deSouza NM (2004) Pretreatment tumour volume measurement on high-resolution magnetic resonance imaging as a predictor of survival in cervical cancer. BJOG 111:741–747CrossRefPubMed
14.
Gilderdale DJ, deSouza NM, Coutts GA, Chui MK, Larkman DJ, Williams AD, Young IR (1999) Design and use of internal receiver coils for magnetic resonance imaging. Br J Radiol 72:1141–1151CrossRefPubMed
15.
Downey K, Jafar M, Attygalle AD, Hazell S, Morgan VA, Giles SL, Schmidt MA, Ind TE, Shepherd JH, deSouza NM (2013) Influencing surgical management in patients with carcinoma of the cervix using a T2- and ZOOM-diffusion-weighted endovaginal MRI technique. Br J Cancer 109:615–622CrossRefPubMedPubMedCentral
16.
Naganawa S, Sato C, Kumada H, Ishigaki T, Miura S, Takizawa O (2005) Apparent diffusion coefficient in cervical cancer of the uterus: comparison with the normal uterine cervix. Eur Radiol 15:71–78CrossRefPubMed
17.
Payne GS, Schmidt M, Morgan VA, Giles S, Bridges J, Ind T, deSouza NM (2010) Evaluation of magnetic resonance diffusion and spectroscopy measurements as predictive biomarkers in stage 1 cervical cancer. Gynecol Oncol 116:246–252CrossRefPubMed
18.
Charles-Edwards EM, Messiou C, Morgan VA, De Silva SS, Mcwhinney NA, Katesmark M, Attygalle AD, deSouza NM (2008) Diffusion-weighted imaging in cervical cancer with an endovaginal technique: potential value for improving tumor detection in stage Ia and Ib1 disease. Radiology 249:541–550CrossRefPubMed
19.
Wheeler-Kingshott CA, Parker GJ, Symms MR et al (2002) ADC mapping of the human optic nerve: increased resolution, coverage, and reliability with CSF-suppressed ZOOM-EPI. Magn Reson Med 47:24–31CrossRefPubMed
20.
Downey K, Shepherd JH, Attygalle AD, Hazell S, Morgan VA, Giles SL, Ind TE, deSouza NM (2014) Preoperative imaging in patients undergoing trachelectomy for cervical cancer: validation of a combined T2- and diffusion-weighted endovaginal MRI technique at 3.0 T. Gynecol Oncol 133:326–332CrossRefPubMedPubMedCentral
21.
Charles-Edwards E, Morgan V, Attygalle AD, Giles SL, Ind TE, Davis M, Shepherd J, Mcwhinney N, deSouza NM (2011) Endovaginal magnetic resonance imaging of stage 1A/1B cervical cancer with A T2- and diffusion-weighted magnetic resonance technique: effect of lesion size and previous cone biopsy on tumor detectability. Gynecol Oncol 120:368–373CrossRefPubMed
22.
Turkbey B, Merino MJ, Gallardo EC, Shah V, Aras O, Bernardo M, Mena E, Daar D, Rastinehad AR, Linehan WM, Wood BJ, Pinto PA, Choyke PL (2014) Comparison of endorectal coil and nonendorectal coil T2W and diffusion-weighted MRI at 3 Tesla for localising prostate cancer: correlation with whole-mount histopathology. J Magn Reson Imaging 39:1443–1448CrossRefPubMedPubMedCentral
23.
Korn N, Kurhanewicz J, Banerjee S, Starobinets O, Saritas E, Noworolski S (2015) Reduced-FOV excitation decreases susceptibility artifact in diffusion-weighted MRI with endorectal coil for prostate cancer detection. Magn Reson Imaging 33:56–62CrossRefPubMedPubMedCentral
24.
Nowak J, Malzahn U, Baur AD, Reichelt U, Franiel T, Hamm B, Durmus T (2014) The value of ADC, T2 signal intensity, and a combination of both parameters to assess Gleason score and primary Gleason grades in patients with known prostate cancer. Acta Radiol
25.
Riches SF, Payne GS, Morgan VA, Sandhu S, Fisher C, Germuska M, Collins DJ, Thompson A, deSouza NM (2009) MRI in the detection of prostate cancer: combined apparent diffusion coefficient, metabolite ratio, and vascular parameters. AJR Am J Roentgenol 193:1583–1591CrossRefPubMed
26.
Lakhman Y, Akin O, Park KJ, Sarasohn DM, Zheng J, Goldman DA, Sohn MJ, Moskowitz CS, Sonoda Y, Hricak H, Abu-Rustum NR (2013) Stage IB1 cervical cancer: role of preoperative MR imaging in selection of patients for fertility-sparing radical trachelectomy. Radiology 269:149–158CrossRefPubMed
27.
Malkyarenko DI, Chenevert TL (2014) Practical estimate of gradient nonlinearity for implementation of apparent diffusioncoefficient bias correction. J Magn Reson Imaging 40:1487–1495CrossRefPubMed
28.
Sakamoto J, Imaizumi A, Sasaki Y, Kamio T, Wakoh M, Otonari-Yamamoto M, Sano T (2014) Comparison of accuracy of intravoxel incoherent motion and apparent diffusioncoefficient techniques for predicting malignancy of head and neck tumors using half-Fourier single-shot turbo spin-echo diffusion-weighted imaging. Magn Reson Imaging 32:860–866CrossRefPubMed
29.
Hori M, Kim T, Onishi H, Imaoka I, Kagawa Y, Murakami T, Nakamoto A, Ueguchi T, Tatsumi M, Enomoto T, Kimura T, Tomiyama N (2013) Endometrial cancer: preoperative staging using three-dimensional T2-weighted turbo spin-echo and diffusion-weighted MR imaging at 3.0 T: a prospective comparative study. Eur Radiol 23:2296–2305CrossRefPubMed
30.
Lee CY, Li Z, Pipe JG, Debbins JP (2013) Turboprop+: enhanced Turboprop diffusion-weighted imaging with a new phase correction. Magn Reson Med 70:497–503CrossRefPubMed
31.
Hoogendam JP, Klerkx WM, De Kort GA, Bipat S, Zweemer RP, Sie-Go DM, Verheijen RH, Mali WP, Veldhuis WB (2010) The influence of the b-value combination on apparent diffusion coefficient based differentiation between malignant and benign tissue in cervical cancer. J Magn Reson Imaging 32:376–382CrossRefPubMed
32.
Hori M, Kim T, Murakami T, Imaoka I, Onishi H, Tomoda K, Tsutsui T, Enomoto T, Kimura T, Nakamura H (2009) Uterine cervical carcinoma: preoperative staging with 3.0-T MR imaging--comparison with 1.5-T MR imaging. Radiology 251:96–104CrossRefPubMed
33.
Mitchell DG, Snyder B, Coakley F, Reinhold C, Thomas G, Amendola M, Schwartz LH, Woodward P, Pannu H, Hricak H (2006) Early invasive cervical cancer: tumor delineation by magnetic resonance imaging, computed tomography, and clinical examination, verified by pathologic results, in the ACRIN 6651/GOG 183 Intergroup Study. J Clin Oncol 24:5687–5694CrossRefPubMed
Metadata
Title
Comparison of optimised endovaginal vs external array coil T2-weighted and diffusion-weighted imaging techniques for detecting suspected early stage (IA/IB1) uterine cervical cancer
Authors
Kate Downey
Ayoma D. Attygalle
Veronica A. Morgan
Sharon L. Giles
A. MacDonald
M. Davis
Thomas E. J. Ind
John H. Shepherd
Nandita M. deSouza
Publication date
01-04-2016
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 4/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-015-3899-5

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