Use of Myometrium as an Internal Reference for Endometrial and Cervical Cancer on Multiphase Contrast-Enhanced MRI.

Published on Jun 21, 2016in PLOS ONE2.776
· DOI :10.1371/JOURNAL.PONE.0157820
Chia-Ni Lin3
Estimated H-index: 3
(Memorial Hospital of South Bend),
Yu-San Liao1
Estimated H-index: 1
(CCU: National Chung Cheng University)
+ 2 AuthorsLi-Wen Lee1
Estimated H-index: 1
(CGUST: Chang Gung University of Science and Technology)
Background Myometrial smooth muscle is normally within the field of view for the gynecological imaging. This study aimed to investigate the use of normal myometrium as an internal reference for endometrial and cervical cancer during multiphase contrast-enhanced magnetic resonance imaging (MCE-MRI) and to explore whether this information regarding tumor enhancement relative to the myometrium could be used to discriminate between endometrial and cervical cancer. Methods MRI images, before and after contrast enhancement, were analyzed in newly diagnosed cervical (n = 18) and endometrial cancer (n = 19) patients. Signal intensities (SIs) from tumor tissue and non-neoplastic myometrium were measured using imaging software. Results The relative signal for cervical cancer was approximately 30% higher than that of endometrial cancer after contrast administration. The area under receiver operating characteristic curve for SI, relative signal enhancement, and tumor to myometrium contrast ratio (as used to discriminate between cervical cancer and endometrial cancer) was 0.7807, 0.7456 and 0.7895, respectively. There was no difference in SI of the normal myometrium between endometrial and cervical cancer patients prior to and after contrast administration. Using non-tumorous myometrium as an internal reference, the tumor to myometrium contrast ratio was significantly higher in tumor tissue from cervical cancer compared with that from endometrial cancer at 25 s post contrast enhancement (p = 0.0016), with an optimal sensitivity of 72.22% and specificity of 84.21%. Conclusion With SI normalized to baseline or normal myometrium, tumor tissue from cervical cancer patients showed significant hyperintensity compared with that of tumor tissue from endometrial cancer patients after contrast enhancement, yielding acceptable performance. The use of the myometrium as an internal reference may provide an alternative method to analyze MCE-MRI data.
  • References (30)
  • Citations (5)
📖 Papers frequently viewed together
2 Citations
78% of Scinapse members use related papers. After signing in, all features are FREE.
#1Martijn Intven (UU: Utrecht University)H-Index: 15
#2Onne Reerink (UU: Utrecht University)H-Index: 17
Last. Marielle E.P. Philippens (UU: Utrecht University)H-Index: 27
view all 3 authors...
BACKGROUND: Patient selection for organ sparing treatment after good response to neo-adjuvant chemoradiation (CRT) for locally advanced rectal cancer is challenging as no optimal restaging modality is available after CRT. In this study, we assessed the value of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) for rectal cancer pathological response prediction. METHODS: In 51 patients with locally advanced rectal cancer, the tumor volume and volume transfer constant (Ktrans) were ob...
53 CitationsSource
#1Charis Bourgioti (UoA: National and Kapodistrian University of Athens)H-Index: 8
#2Konstantinos Chatoupis (UoA: National and Kapodistrian University of Athens)H-Index: 6
Last. Lia A. Moulopoulos (UoA: National and Kapodistrian University of Athens)H-Index: 30
view all 7 authors...
Purpose To report discriminant MRI features between cervical and endometrial carcinomas and to design an MRI- scoring system, with the potential to predict the origin of uterine cancer (cervix or endometrium) in histologically indeterminate cases.
8 CitationsSource
#1Federica Tomao (Sapienza University of Rome)H-Index: 21
#2Anselmo Papa (Sapienza University of Rome)H-Index: 13
Last. Silverio Tomao (Sapienza University of Rome)H-Index: 26
view all 8 authors...
Standard treatment of cervical cancer (CC) consists of surgery in the early stages and of chemoradiation in locally advanced disease. Metastatic CC has a poor prognosis and is usually treated with palliative platinum-based chemotherapy. Current chemotherapeutic regimens are associated with significant adverse effects and only limited activity, making identification of active and tolerable novel targeted agents a high priority. Angiogenesis is a complex process that plays a crucial role in the de...
26 CitationsSource
#1Fahmi Khalifa (University of Louisville)H-Index: 18
#2Ahmed Soliman (University of Louisville)H-Index: 13
Last. Amy C. Dwyer (University of Louisville)H-Index: 10
view all 8 authors...
Purpose: To present a review of most commonly used techniques to analyze dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), discusses their strengths and weaknesses, and outlines recent clinical applications of findings from these approaches. Methods: DCE-MRI allows for noninvasive quantitative analysis of contrast agent (CA) transient in soft tissues. Thus, it is an important and well-established tool to reveal microvasculature and perfusion in various clinical applications. In the...
104 CitationsSource
#1Bang-Bin Chen (NTU: National Taiwan University)H-Index: 16
#2Tiffany Ting-Fang Shih (NTU: National Taiwan University)H-Index: 28
Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) enables tumor vascular physiology to be assessed. Within the tumor tissue, contrast agents (gadolinium chelates) extravasate from intravascular into the extravascular extracellular space (EES), which results in a signal increase on T1-weighted MRI. The rate of contrast agents extravasation to EES in the tumor tissue is determined by vessel leakiness and blood flow. Thus, the signal measured on DCE-MRI represents a combination of perm...
33 CitationsSource
#1Demet Dogan (Kocaeli University)H-Index: 1
#2Nagihan Inan (Kocaeli University)H-Index: 15
Last. Ali Demirci (Kocaeli University)H-Index: 19
view all 8 authors...
Purpose To evaluate the diagnostic accuracy of 3T MRI in preoperative staging of myometrial invasion.
13 CitationsSource
#1Wijnand J. Alberda (EUR: Erasmus University Rotterdam)H-Index: 6
#2Helene P. N. Dassen (EUR: Erasmus University Rotterdam)H-Index: 1
Last. Cornelis Verhoef (EUR: Erasmus University Rotterdam)H-Index: 42
view all 8 authors...
Purpose The usefulness of restaging by magnetic resonance imaging (MRI) after chemoradiotherapy (CTx/RTx) in patients with locally advanced rectal cancer has not yet been established, mostly due to the difficult differentiation between viable tumor and fibrosis. MRI with dynamic contrast-enhanced (DCE) sequences may be of additional value in distinguishing malignant from nonmalignant tissue. The aim of this study was to assess the accuracy of tumor, nodal staging, and circumferential resection m...
26 CitationsSource
#1Evis Sala (University of Cambridge)H-Index: 43
#2Andrea RockallH-Index: 37
Last. Caroline ReinholdH-Index: 44
view all 5 authors...
Advances in MR imaging techniques, along with the growing role of the radiologist as part of a multidisciplinary treatment-planning team, have become central in tailoring treatment options and frequently lead to modifications in the therapeutic approach in patients with gynecologic malignancies.
158 CitationsSource
#1Sadhna Verma (UC: University of Cincinnati)H-Index: 21
#2Baris TurkbeyH-Index: 55
Last. Mukesh G. HarisinghaniH-Index: 45
view all 8 authors...
OBJECTIVE. This article is a primer on the technical aspects of performing a high-quality dynamic contrast-enhanced MRI (DCE-MRI) examination of the prostate gland. CONCLUSION. DCE-MRI is emerging as a useful clinical technique as part of a multi-parametric approach for evaluating the extent of primary and recurrent prostate cancer. Performing a high-quality DCE-MRI examination requires a good understanding of the technical aspects and limitations of image acquisition and postprocessing techniqu...
165 CitationsSource
#1Do Seon Song (Catholic University of Korea)H-Index: 11
#2Si Hyun Bae (Catholic University of Korea)H-Index: 31
Hepatocellular carcinoma (HCC) is the third most common cause of cancer deaths in the world. There have been many advances in the diagnosis of HCC during the last ten years, especially in the imaging techniques. The Korean Liver cancer study group (KLCSG), European Association for the Study of the Liver (EASL), American Association for the Study of Liver disease (AASLD), and Asian-Pacific Association for the Study of Liver (APASL) have made and changed the HCC guidelines with the advances in the...
50 CitationsSource
Cited By5
#1Gigin Lin (Memorial Hospital of South Bend)H-Index: 16
#2Yu-Chun Lin (Memorial Hospital of South Bend)H-Index: 21
Last. Ji-Hong Hong (Memorial Hospital of South Bend)H-Index: 40
view all 14 authors...
Background A triage test to assist clinical decision-making on choosing primary chemoradiation for cervical carcinomas or primary surgery for endometrial carcinomas is important. Purpose or Hypothesis To develop and validate a multiparametric prediction model based on MR imaging and spectroscopy in distinguishing adenocarcinomas of uterine cervical or endometrial origin. Study Type Prospective diagnostic accuracy study. Population Eighty-seven women: 25 cervical and 62 endometrial adenocarcinoma...
2 CitationsSource
#1Bilgin Keserci (Philips)H-Index: 8
#2Nguyen Minh Duc (Pham Ngoc Thach University of Medicine)H-Index: 4
AbstractObjective: To assess the relationship between magnetic resonance (MR) T1 perfusion-based classification and the outcome of MR-guided high intensity focused ultrasound treatment of adenomyosis, defined as nonperfused volume (NPV) ratio.Methods: The adenomyosis of 31 women was classified into group A (time–signal intensity [SI] curve of adenomyosis lower than that of the myometrium) and group B (time–SI curve of adenomyosis equal to or higher than that of the myometrium) on the basis of ti...
5 CitationsSource
#1Jong Min ParkH-Index: 14
#2So Yeon Park (SNU: Seoul National University)H-Index: 44
Last. Chang Heon Choi (SNU: Seoul National University)H-Index: 9
view all 5 authors...
Abstract Purpose To investigate the plan quality of tri-Co-60 intensity-modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) for cervical cancer. Methods A total of 20 patients who received postoperative radiotherapy for cervical cancer were selected. For each patient, a tri-Co-60 IMRT plan for which the target volume was the planning target volume (PTV) generated by adding 1 mm isotropic margins from the clinical target volume (CTV) and a VMAT plan for which the target...
12 CitationsSource
#1Bilgin Keserci (Philips)H-Index: 8
#2Nguyen Minh Duc (Pham Ngoc Thach University of Medicine)H-Index: 4
Objective To comparatively evaluate the role of magnetic resonance (MR) T1 perfusion-based time–signal intensity (SI) curves of fibroid tissue and the myometrium in classification of fibroids for predicting treatment outcomes of high-intensity focused ultrasound (HIFU) treatment.
5 CitationsSource