Diagnostic and Interventional Radiology
Abdominal Imaging - Original Article

Assessment of pelvic lymph node metastasis in FIGO IB and IIA cervical cancer using quantitative dynamic contrast-enhanced MRI parameters

1.

Departmet of Radiology, Kyungpook National University School of Medicine,, Kyungpook National University Chilgok Hospital, Daegu, Korea

Diagn Interv Radiol 2020; 26: 382-389
DOI: 10.5152/dir.2020.19365
Read: 184 Downloads: 145 Published: 09 December 2019

PURPOSE

We prospectively determined whether the quantitative parameters derived from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) are useful for predicting pelvic lymph node (LN) status in cervical cancer through node-by-node pathologic validation of images.

 

METHODS

Overall, 182 LNs harvested from 200 consecutive patients with 2018 FIGO stage IB-IIA cervical cancer (82 metastatic and 100 nonmetastatic) were used for node-by-node assessment. Each LN was quantitatively assessed using Ktrans, Ve, and Kep values. The short-axis diameter, ratio of the long-axis to short-axis diameter, and long-axis diameter were also assessed. Data on metastatic LNs were divided into four groups according to the FIGO staging system. Receiver operating characteristic (ROC) curve analysis was performed to evaluate statistically significant parameters derived from DCE-MRI for the differentiation of metastatic LNs from nonmetastatic LNs.

 

RESULTS

The mean short-axis diameter of metastatic LNs was significantly larger than that of nonmetastatic LNs (all P < 0.05) despite several overlaps. In comparison with nonmetastatic LNs, metastatic LNs showed a significantly lower Ktrans (all P < 0.05); however, Kep and Ve were not significantly different (all P > 0.05). For IB3 and IIA2 cervical cancer, Ktrans had moderate diagnostic ability for differentiating metastatic LNs from nonmetastatic LNs (for IB3: area under the curve [AUC] 0.740, 95% CI 0.657–0.838, 61.7% sensitivity,  80.2% specificity, P = 0.007; for IIA2: AUC 0.786, 95% CI 0.650–0.846, 60.2% sensitivity, 81.8% specificity, P = 0.008).

 

CONCLUSION

Ktrans appears to be a useful parameter for detecting metastatic LNs, especially for IB3 and IIA2 cervical cancer.

 

You may cite this article as: Kim SH, Cho SH. Assessment of pelvic lymph node metastasis in FIGO IB and IIA cervical cancer using quantitative dynamic contrast-enhanced MRI parameters. Diagn Interv Radiol 2020; 26:382–389

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