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. 2022 Jul 22:15:6279-6288.
doi: 10.2147/IJGM.S372154. eCollection 2022.

Diagnostic Value of Multimodal Magnetic Resonance Imaging in Discriminating Between Metastatic and Non-Metastatic Pelvic Lymph Nodes in Cervical Cancer

Jian Xu #  1 , Yingli Ma #  2 , Haibing Mei  1 , Qimin Wang  1
Affiliations

Diagnostic Value of Multimodal Magnetic Resonance Imaging in Discriminating Between Metastatic and Non-Metastatic Pelvic Lymph Nodes in Cervical Cancer

Jian Xu et al. Int J Gen Med. .

Abstract

Background: The status of pelvic lymph node (PLN) metastasis affects treatment and prognosis plans in patients with cervical cancer. However, it is hard to be diagnosed in clinical practice.

Purpose: The present study aimed to evaluate the diagnostic value of multimodal magnetic resonance imaging (MRI) in discriminating between metastatic and non-metastatic pelvic lymph nodes (PLNs) in cervical cancer.

Methods: This retrospective study analyzed MRIs of 209 PLNs in 25 women with pathologically proven cervical cancer. All PLNs had been assessed by pre-treatment multimodal MRIs, and their status was finally confirmed by histopathology. In conventional MRI, lymph node characteristics were compared between metastatic and non-metastatic PLNs. Signal intensity, time-intensity curve (TIC) patterns minimal and mean apparent diffusion coefficients (ADC) were compared between them in DWI. In DCE-MRI, quantitative (Ktrans, Kep and Ve) analyses were performed on DCE-MRI sequences, and their predictive values were analyzed by ROC curves.

Results: Of 209 PLNs, 22 (10.53%) were metastases and 187 (89.47%) were non-metastases at histopathologic examination. Considering a comparison of lymph node characteristics, the short axis size, the long axis size, and the boundary differed significantly between the two groups (P<0.05).The differences in ADCmin, TIC types, Ktrans and Ve between metastatic and non-metastatic PLNs were significant as well (P<0.05). The good diagnostic performance of multimodal MRI was shown in discriminating between metastatic and non-metastatic PLNs, with the sensitivity of 85.0% (17/20), specificity of 97.3% (184/189), and accuracy of 96.2% (201/209). ROC analyses showed that the diagnostic accuracy of ADCmin, Ktrans and Ve for discriminating between metastatic and non-metastatic PLNs in cervical cancer was 83.7%, 91.4%, and 92.4% with the cut-off values of 0.72 × 10-3mm2/s, 0.52 min-1, and 0.53 min-1, respectively.

Conclusion: Multimodal MRI showed good diagnostic performance in determining PLN status in cervical cancer.

Keywords: apparent diffusion coefficient; cervical cancer; lymphatic metastasis; multimodal magnetic resonance imaging.

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Conflict of interest statement

The authors declare that there are no conflicts of interest.

Figures

Figure 1
Figure 1
STARD flow diagram of multimodal MRI in discriminating between metastatic and non-metastatic pelvic lymph nodes in 25 patients with cervical cancer.
Figure 2
Figure 2
A 58-year-old woman with cervical cancer. (A) AxialT1WI shows a metastatic pelvic lymph node with hyperintense (white arrow). (B) Axial DWI shows a metastatic pelvic lymph node with hyperintense (white arrow). (C) Axial T2WI SPAIR shows a metastatic pelvic lymph node with hyperintense (white arrow). (D) Axial DWI shows a metastatic pelvic lymph node presented in TIC type III. (E) Image of Ktrans shows a metastatic pelvic lymph node in warm color (white arrow). (F) Image of Ve shows a metastatic pelvic lymph node in warm color (white arrow).
Figure 3
Figure 3
Box and whisker plot comparing the minimum value of ADC of true-positive, false-negative, false-positive, true-negative pelvic lymph nodes diagnosed by multimodal MRI.
Figure 4
Figure 4
Box and whisker plot comparing the value of Ktrans of true-positive, false-negative, false-positive, true-negative pelvic lymph nodes diagnosed by multimodal MRI.
Figure 5
Figure 5
Box and whisker plot comparing the value of Ve of true-positive, false-negative, false-positive, true-negative pelvic lymph nodes diagnosed by multimodal MRI.
Figure 6
Figure 6
ROC curves of ADCmin, Ktrans and Ve in discriminating between metastatic and non-metastatic PLNs in cervical cancer.
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References

    1. Cohen PA, Jhingran A, Oaknin A, Denny L. Cervical cancer. Lancet. 2019;393(10167):169–182. - PubMed
    1. Matsuo K, Machida H, Mandelbaum RS, Konishi I, Mikami M. Validation of the 2018 FIGO cervical cancer staging system. Gynecol Oncol. 2019;152(1):87–93. - PMC - PubMed
    1. Tang L, Zhou XJ. Diffusion MRI of cancer: from low to high b-values. J Magnetic Resonance Imaging. 2019;49(1):23–40. - PMC - PubMed
    1. Thomassin-Naggara I, Bazot M, Daraï E, Callard P, Thomassin J, Cuenod CA. Epithelial ovarian tumors: value of dynamic contrast-enhanced MR imaging and correlation with tumor angiogenesis. Radiology. 2008;248(1):148–159. - PubMed
    1. Yan Y, Sun X, Shen B. Contrast agents in dynamic contrast-enhanced magnetic resonance imaging. Oncotarget. 2017;8(26):43491–43505. - PMC - PubMed