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- Title
USPIO-enhanced MRI for preoperative staging of gynecological pelvic tumors: preliminary results.
- Authors
Keller, Thomas M.; Michel, Sven C. A.; Fröhlich, Johannes; Fink, Daniel; Caduff, Rosmarie; Marincek, Borut; Kubik-Huch, Rahel A.; Fröhlich, Johannes
- Abstract
The aim of this study was to assess nodal enhancement with ultrasmall superparamagnetic iron oxide (USPIO)-enhanced magnetic resonance imaging (MRI) during preoperative staging of gynecological pelvic tumors within the same imaging session for the primary tumor. Pelvic MRI was performed 18-28 h after intravenous infusion of USPIO (Combidex/Sinerem, 2.6 mg Fe/kg body weight) in 13 women (mean age 51 years) scheduled for surgery for biopsy proven ( n=11) or clinically suspected ( n=2) uterine carcinoma. Axial T1-weighted spin-echo (SE), T2-weighted fast SE (FSE; with fat saturation), fast spoiled gradient-recalled (FSPGR) echo, sagittal and oblique T2-weighted FSE sequences were acquired on a 1.5-T system. Lymph nodes were prospectively staged using standard criteria, i.e., size and shape, as well as USPIO enhancement. Results were correlated with histology findings. MRI correctly staged all primary uterine tumors. In one case, the preoperative diagnosis of stage IV switched the therapeutic approach to radiochemotherapy. Ninety-one (86 benign, 5 malignant) of the histologically characterized nodes could be correlated with their MRI counterparts. One node was false positive; three micrometastases greater than 5 mm and one 5-mm metastasis were missed. On a nodal basis, the sensitivity score was 0.33 and the specificity score, 0.99. On a patient basis, the sensitivity score was 0.25 and the specificity score, 0.80. Our preliminary results indicate that USPIO-enhanced pelvic MRI for preoperative nodal assessment is feasible within one imaging session for primary tumors and that it has a high specificity. However, the low sensitivity in the present study is a limitation for the clinical application of this technique.
- Subjects
CANCER invasiveness; MAGNETIC resonance microscopy; INTRAVENOUS therapy; WEIGHT gain; LYMPH nodes; DIAGNOSTIC imaging; CERVIX uteri tumors; COMPARATIVE studies; DEXTRAN; FEMALE reproductive organ tumors; IRON; IRON compounds; MAGNETIC resonance imaging; RESEARCH methodology; MEDICAL cooperation; OXIDES; PELVIC tumors; PLANTS; PREOPERATIVE care; RESEARCH; TUMOR classification; PILOT projects; UTERINE tumors; EVALUATION research; DIAGNOSIS
- Publication
European Radiology, 2004, Vol 14, Issue 6, p937
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-004-2258-8