Diagnostic Performance of MRI for Assessing Parametrial Invasion in Cervical Cancer: A Head-to-Head Comparison between Oblique and True Axial T2-Weighted Images

Korean Journal of Radiology : Official Journal of the Korean Radiological Society
Sungmin WooSang Youn Kim

Abstract

To directly compare the diagnostic performance of true and oblique axial T2-weighted imaging (T2WI) for assessing parametrial invasion (PMI) in cervical cancer. This retrospective study included 71 women with treatment-naive cervical cancer who underwent MRI that included both oblique and true axial T2WI, followed by radical hysterectomy. Two blinded radiologists (Radiologist 1 and Radiologist 2) independently assessed the presence of PMI on both sequences using a 5-point Likert scale. Receiver operating characteristic (ROC) curve analysis was performed, with a subgroup analysis for tumors sized > 2.5 cm and ≤ 2.5 cm in diameter. Inter-reader agreement was assessed with kappa (k) statistics. At hysterectomy, 15 patients (21.1%) had PMI. For Radiologist 1, the area under the ROC curve (AUC) was greater for oblique axial than for true axial T2WI {0.941 (95% confidence interval [CI] = 0.858-0.983) vs. 0.917 (95% CI = 0.827-0.969), p = 0.027}. The difference was not significant for Radiologist 2 (0.879 [95% CI = 0.779-0.944] vs. 0.827 [95% CI = 0.719-0.906], p = 0.153). For tumors > 2.5 cm, AUC was greater with oblique than with true axial T2WI (0.906 vs. 0.860, p = 0.046 for Radiologist 1 and 0.839 vs. 0.765, p = 0.086 for Radiolo...Continue Reading

References

Jul 31, 1999·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·S PecorelliJ H Shepherd
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Jan 13, 2012·CA: a Cancer Journal for Clinicians·Rebecca SiegelAhmedin Jemal
Apr 29, 2014·Gynecologic Oncology·Jung-Yun LeeYong-Sang Song
Jul 16, 2014·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Gaiane M RauchLeonardo P Marcal
Sep 24, 2015·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·Evis SalaHebert Alberto Vargas
Oct 30, 2015·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·Tae-Wook KongHee-Sug Ryu

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