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European Radiology
Published in: European Radiology 3/2020

01-03-2020 | Magnetic Resonance Imaging | Urogenital

Diagnostic performance of MR imaging in evaluating prognostic factors in patients with cervical cancer: a meta-analysis

Authors: Meiling Xiao, Bicong Yan, Ying Li, Jingjing Lu, Jinwei Qiang

Published in: European Radiology | Issue 3/2020

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Abstract

Objectives

This study aims to determine the diagnostic performance of conventional magnetic resonance imaging (MRI) in assessing the distance between the tumor and the internal os, stromal infiltration, lymph node metastasis, and parametrial invasion in patients with cervical cancer.

Methods

A systematic English-language literature search of conventional MRI in the evaluation of human cervical cancer was performed in the PubMed, Cochrane Library, Embase, and Web of Science databases from 1995 to 2018. The pooled sensitivity, specificity, diagnostic odds ratio (DOR), and positive and negative likelihood ratios (PLR and NLR) of all studies were calculated. The results were then plotted in a hierarchical summary receiver operating characteristic (HSROC) plot, and meta-regression and subgroup analyses of the parametrial invasion were also performed.

Results

The pooled sensitivity, specificity, DOR, PLR, and NLR were 86%, 97%, 167.91, 24.74, and 0.15, respectively, in evaluating the internal os involvement (6 studies, 454 patients); 87%, 91%, 73.41, 10.22, and 0.14, respectively, in evaluating the stromal infiltration (11 studies, 672 patients); 51%, 89%, 8.63, 4.72, and 0.55, respectively, in evaluating the lymph node metastasis (15 studies, 997 patients); and 75%, 92%, 34.01, 9.38, and 0.28, respectively, in evaluating the parametrial invasion (19 studies, 1748 patients). The meta-regression of the parametrial invasion showed that the application of contrast enhancement was a significant factor affected the heterogeneity (p = 0.039).

Conclusions

Conventional MRI can accurately evaluate the distance between the tumor and the internal os, as well as stromal infiltration, and performs well in diagnosing the parametrial invasion. However, this method exhibited a limited ability in diagnosing the lymph node metastasis.

Key Points

• MRI can help clinicians to accurately assess the distance between the tumor and the internal os, stromal infiltration, and parametrial invasion in patients with uterine cervical neoplasms.
• MRI exhibits a limited ability in diagnosing the lymph node metastasis.
• Management of patients with uterine cervical neoplasms becomes more appropriate.
Appendix
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Metadata
Title
Diagnostic performance of MR imaging in evaluating prognostic factors in patients with cervical cancer: a meta-analysis
Authors
Meiling Xiao
Bicong Yan
Ying Li
Jingjing Lu
Jinwei Qiang
Publication date
01-03-2020
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 3/2020
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-019-06461-9

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