Diagnostic Performance of Nanoparticle-Enhanced Magnetic Resonance Imaging in the Diagnosis of Lymph Node Metastases in Patients With Endometrial and Cervical Cancer

2005 ◽  
Vol 23 (12) ◽  
pp. 2813-2821 ◽  
Author(s):  
Andrea G. Rockall ◽  
Syed A. Sohaib ◽  
Mukesh G. Harisinghani ◽  
Syed A. Babar ◽  
Naveena Singh ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Lymph Node ◽  
Magnetic Resonance ◽  
Lymph Node Metastases ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Resonance Imaging ◽  
Lymph Node Sampling ◽  
Node Metastases ◽  
Sensitivity Specificity

Purpose Lymph node metastases affect management and prognosis of patients with gynecologic malignancies. Preoperative nodal assessment with computed tomography or magnetic resonance imaging (MRI) is inaccurate. A new lymph node–specific contrast agent, ferumoxtran-10, composed of ultrasmall particles of iron oxide (USPIO), may enhance the detection of lymph node metastases independent of node size. Our aim was to compare the diagnostic performance of MRI with USPIO against standard size criteria. Methods Forty-four patients with endometrial (n = 15) or cervical (n = 29) cancer were included. MRI was performed before and after administration of USPIO. Two independent observers viewed the MR images before lymph node sampling. Lymph node metastases were predicted using size criteria and USPIO criteria. Lymph node sampling was performed in all patients. Results Lymph node sampling provided 768 pelvic or para-aortic nodes for pathology, of which 335 were correlated on MRI; 17 malignant nodes were found in 11 of 44 patients (25%). On a node-by-node basis, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) by size criteria were 29%*, 99%, 56%, and 96%, and by USPIO criteria (reader 1/reader 2) were 93%/82%* (*P = .008/.004), 97%/97%, 61%/59%, and 100%/99%, respectively (where [*] indicates the statistical difference of P = x/x between the two results marked by the asterisk). On a patient-by-patient basis, sensitivity, specificity, PPV, and NPV by size criteria were 27%*, 94%, 60%, and 79%, and by USPIO criteria (reader 1/reader 2) were 100%/91%* (*P = .031/.06), 94%/87%, 82%/71%, and 100%/96%, respectively. The κ statistic was 0.93. Conclusion Lymph node characterization with USPIO increases the sensitivity of MRI in the prediction of lymph node metastases, with no loss of specificity. This may greatly improve preoperative treatment planning.

scholarly journals Diagnostic Value of Magnetic Resonance Imaging (MRI), Computed Tomography (CT) and Positron Emission Tomography (PET) in the Detection of Lymph Node Metastases in Gynaecologic Cancers

2019 ◽  
Vol 4 (2) ◽  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Lymph Node ◽  
Magnetic Resonance ◽  
Lymph Node Metastases ◽  
Predictive Value ◽  
Diagnostic Value ◽  
Emission Tomography ◽  
Resonance Imaging ◽  
Node Metastases ◽  
Magnetic Resonance Imaging Mri

Background: A factor that affects the staging of gynaecological cancers is the status of adenopathy’s and imaging tests are a fundamental part of staging. Primary Objective: To assess the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) in the detection of pathological lymphadenopathies in gynaecological cancers of magnetic resonance imaging (MRI), computerized axial tomography (CAT) and positrons emission tomography (PET). Study Hypothesis: Imaging tests are not as valid as lymphadenectomy for the diagnosis of pathological lymphadenopathies. Trial Design: Retrospective study performed in the gynaecological oncology unit of a tertiary hospital. Major Inclusion/Exclusion Criteria: Patients diagnosed with genital cancer (endometrium, ovary or cervix) in the period between January 1, 2014 and December 31, 2018, who meet the following inclusion criteria: (i) have requested a diagnostic test of image (RNM, CT or PET-CT) prior to undergoing surgery; (ii) have undergone surgery for the treatment of cancer and (iii) have undergone lymphadenectomy, pelvic and / or para-aortic, during surgery. Primary Endpoint: Correlation between the imaging tests and the anatomopathological result of the lymph node biopsies. Sample Size: 219 patients who underwent pelvic, para-aortic lymphadenectomy or both due to cancer of the endometrium, ovary or cervix, and at least one imaging test prior to surgery. Results: In our study, PET presents the highest sensitivity (42%) of the diagnostic tests evaluated, the TAC the highest specificity (95%) and the highest PPV (77%) and the MRI the highest NPV (76%). Conclusions: The diagnostic value of imaging tests in the detection of lymph node metastases in gynaecological cancers is limited.

scholarly journals Detection of Lymph Node Metastases by Gadolinium-Enhanced Magnetic Resonance Imaging: Systematic Review and Meta-analysis

2010 ◽  
Vol 102 (4) ◽  
pp. 244-253 ◽  
Author(s):  
Wenche M. Klerkx ◽  
Leon Bax ◽  
Wouter B. Veldhuis ◽  
A. Peter M. Heintz ◽  
Willem PThM. Mali ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Systematic Review ◽  
Lymph Node ◽  
Magnetic Resonance ◽  
Lymph Node Metastases ◽  
Meta Analysis ◽  
Resonance Imaging ◽  
Node Metastases

scholarly journals Preoperative diagnosis of lymph node metastases in gastric cancer by magnetic resonance imaging with ferumoxtran-10

2006 ◽  
Vol 9 (2) ◽  
pp. 120-128 ◽  
Author(s):  
Yoshiaki Tatsumi ◽  
Nobuhiko Tanigawa ◽  
Haruto Nishimura ◽  
Eiji Nomura ◽  
Hideaki Mabuchi ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Gastric Cancer ◽  
Lymph Node ◽  
Magnetic Resonance ◽  
Lymph Node Metastases ◽  
Preoperative Diagnosis ◽  
Resonance Imaging ◽  
Node Metastases

scholarly journals Comparative study of cardiac magnetic resonance imaging and transesophageal echocardiography in detection of left atrial and left atrial appendage thrombi

2021 ◽  
Vol 22 (Supplement_2) ◽  
Author(s):  
H Shahawy ◽  
A Al Agha ◽  
M Helmy
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Predictive Value ◽  
Left Atrial ◽  
Diagnostic Performance ◽  
Left Atrial Appendage ◽  
Invasive Technique ◽  
Resonance Imaging ◽  
Sensitivity Specificity

Abstract Funding Acknowledgements Type of funding sources: None. Background Left atrial (LA) thrombi are the most common intracardiac masses. Left atrial appendage (LAA) is the most common site for thrombus formation in patients with atrial fibrillation (AF), and in patients with valvular lesions. Transesophageal echocardiography (TEE) has been the conventional investigation for thrombus detection. However, because TEE is a semi-invasive technique; a completely non-invasive technique would be of great concern.  Purpose  The aim of this study is to evaluate the feasibility and diagnostic performance of cardiac magnetic resonance imaging (CMR), for the assessment of thrombi in the left atrium and left atrial appendage (LA/ LAA). Also whether CMR is comparable to TEE in identification and measurement of thrombus size. Methods We studied 43 patients who were diagnosed to have LA/LAA thrombus, or highly suspected thrombus by TEE. They underwent multisequence CMR for assessment of thrombus detection; within 7 days of TEE performance. Data collected from CMR study were statistically analyzed to evaluate for sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) and overall accuracy of detection of LA/LAA thrombus using TEE as the gold standard. Also agreement between both imaging techniques was assessed using kappa agreement coefficient. We conducted a questionnaire where 10 questions were asked to every patient in the study. It aimed to obtain an idea about patients’ opinion of both tests. Results During the study period of 13 months, 43 patients were assessed. Twenty one patients had AF and 22 patients were in sinus rhythm. The median CHA2DS2VASc score of AF patients was 2.52 ± 1.12, and 76.7% of patients were undergoing anticoagulation therapy. In all subjects, the LAA was readily visualized with CMR. When evaluating the diagnostic performance of CMR results revealed overall sensitivity, specificity, PPV, NPV and accuracy of 97.44%, 75%, 97.44%, 75% and 95.35% respectively. Results of questionnaire was statistically significant p value yielding good overall opinion for the sake of CMR. There was an additional role for CMR regarding tissue characterization; where CMR detected 3 cases, diagnosed by TEE as thrombus, 1 case revealed Libman-Sacks Endocarditis and 2 cases revealed fibroelastoma. This made a paradigm shift in patient management. Conclusion CMR is a noninvasive, feasible and comparable modality for thrombus detection in the LA and LAA and could be a reasonable, more comfortable alternative to TEE.

Sign in / Sign up

Export Citation Format

Share Document