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European Radiology
Published in: European Radiology 2/2018

01-02-2018 | Urogenital

Magnetic resonance imaging for detection of parametrial invasion in cervical cancer: An updated systematic review and meta-analysis of the literature between 2012 and 2016

Authors: Sungmin Woo, Chong Hyun Suh, Sang Youn Kim, Jeong Yeon Cho, Seung Hyup Kim

Published in: European Radiology | Issue 2/2018

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Abstract

Objective

To review the diagnostic performance of MRI for detection of parametrial invasion (PMI) in cervical cancer patients.

Methods

MEDLINE and EMBASE databases were searched for studies providing diagnostic performance of MRI for detecting PMI in patients with cervical cancer. Studies published between 2012 and 2016 using surgico-pathological results as reference standard were included. Study quality was evaluated using QUADAS-2. Sensitivity and specificity of all studies were calculated. Results were pooled and plotted in a hierarchical summary receiver operating characteristic plot. Meta-regression and subgroup analyses were performed.

Results

Fourteen studies (1,028 patients) were included. Study quality was generally moderate. Pooled sensitivity was 0.76 (95% CI 0.67–0.84) and specificity was 0.94 (95% CI 0.91–0.95). The possibility of heterogeneity was considered low: Cochran’s Q-test (p = 0.471), Tau2 (0.240), Higgins I2 (0%). With meta-regression analysis, magnet strength, use of DWI, and antispasmodic drugs were significant factors affecting heterogeneity (p < 0.01). Subgroup analysis for studies solely using radical hysterectomy as reference standard yielded pooled sensitivity and specificity of 0.73 (95% CI 0.60–0.83) and 0.93 (95% CI 0.90–0.95), respectively.

Conclusions

MRI shows good performance for detection of PMI in cervical cancer. Using 3-T scanners and DWI may improve diagnostic performance.

Key Points

• MRI shows good performance for detection of parametrial invasion in cervical cancer.
• Subgroup of studies using only radical hysterectomy showed consistent results.
• Using 3-Tesla scanners and diffusion-weighted imaging may improve diagnostic performance.
Appendix
Available only for authorised users
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Metadata
Title
Magnetic resonance imaging for detection of parametrial invasion in cervical cancer: An updated systematic review and meta-analysis of the literature between 2012 and 2016
Authors
Sungmin Woo
Chong Hyun Suh
Sang Youn Kim
Jeong Yeon Cho
Seung Hyup Kim
Publication date
01-02-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 2/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-4958-x

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