Craniocaudal tumour extension in uterine cervical cancer on MRI compared to histopathology. (2015)

• Record Type: Journal Article
• Authors: de Boer, Peter; Bleeker, Maaike C.G.; Spijkerboer, Anje M.; van de Schoot, Agustinus J.A.J.; Bipat, Shandra; Buist, Marrije R.; Rasch, Coen R.N.; Stoker, Jaap; Stalpers, Lukas J.A.
• Is Part Of: European journal of radiology open. Volume 2(2015)
• Page Start: 111
• Page End: 117
• Publication Date: 2015
• Subjects: CI confidence interval -- CRF case record form -- CTV clinical target volume -- EBRT external beam radiation therapy -- ESTRO European society of therapeutic radiology and oncology -- FIGO international federation of gynaecology and obstetrics -- ICC intraclass correlation coefficient -- JCOG Japan clinical oncology group -- LLETZ large loop excision of the transformation zone -- MRI magnetic resonance imaging -- NCIC national cancer institute of Canada -- PTV planning target volume -- RT radiation therapy -- SD standard deviation -- VMAT volumetric modulated arc therapy; Uterine cervical cancer -- MRI -- Accuracy -- Craniocaudal -- Extension; Medical radiology -- Periodicals; 616.075705
• DOI: 10.1016/j.ejro.2015.07.001
• Languages: English
• ISSNs: 2352-0477

Abstract

Highlights: Median craniocaudal extension of uterine cervical cancer on MRI is systematically slightly smaller compared to histopathology (2.1 vs. 2.5 cm). Pearson's correlation: 0.83 ( p < 0.001). Regarding the craniocaudal extension on MRI, 91% (19/21) of the extension would have been covered by a clinical uncertainty margin of 1.2 cm. Comparison of tumour measurements on MRI and surgical specimen is hampered by organ deformation. However, this methodological limitation might be solved by use of deformable image registration. Abstract: Purpose: To assess the reliability of magnetic resonance imaging (MRI) for evaluation of craniocaudal tumour extension by comparing the craniocaudal tumour extension on the pre-operative MRI and post-operative hysterectomy specimen in patients with early stage uterine cervical cancer. Materials and methods: After approval of the institutional review board was acquired, pre-operative MRI and hysterectomy specimen of 21 women with early stage cervical cancer were re-evaluated. The craniocaudal extension on MRI was measured separately by two experienced radiologists and compared with corresponding measurements from the hysterectomy specimen, which were re-evaluated by an experienced pathologist. Results: Median craniocaudal extension of uterine cervical cancer on MRI was slightly smaller compared to histopathology (2.1 cm vs. 2.5 cm). The median underestimation was 0.4 cm (range −0.6 cm to 2.2 cm, mean 0.4 cm, standard deviation (SD) ±0.7 cm); Pearson's correlation was 0.83 ( p < 0.001). In two patients (9%) MRI underestimated tumour craniocaudal extension by more than 1.8 cm. Conclusion: MRI represents the histopathological craniocaudal tumour extension in the majority of patients with early stage uterine cervical cancer, but with a systematic small underestimation of the real craniocaudal tumour extension.