Irradiation of the cervix uteri: value of unenhanced and contrast-enhanced MR imaging.
OBJECTIVE
To analyze the value of magnetic resonance (MR) imaging after radiation therapy for cancer of the cervix.


METHODS
Eighty-nine MR images were retrospectively studied in 69 patients aged 46.3 years +/- 11.5. MR findings of tumor recurrence and irradiation changes were correlated with time after radiation therapy; paracentral radiation dose (dose to point A); and in patients with pretreatment images, primary tumor size and stage.


RESULTS
Overall accuracy of MR in diagnosis of tumor recurrence was 78% (positive predictive value, 65%; negative predictive value, 97%). In MR examinations less than 6 months after the beginning of radiation therapy, accuracy (69%) and specificity (46%) were significantly lower than in examinations more than 6 months later (88%, P = .0032; 81%, P = .0166, respectively). Comparison of pre- and posttreatment MR findings and knowledge of stage or initial tumor size did not affect MR results.


CONCLUSIONS
Overall, diagnosis was best with unenhanced T2-weighted images, but in patients with adnexal or pelvic sidewall recurrence and in patients with treatment complications (eg, fistula formation), contrast enhancement did help.
Hricak
H
H
Department of Radiology, University of California, San Francisco 94143-0628.
Swift
P S
PS
Campos
Z
Z
Quivey
J M
JM
Gildengorin
V
V
Göranson
H
H
D000230:Adenocarcinoma / Q000473:pathology / Q000532:radiotherapy; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy; D002584:Cervix Uteri / Q000473:pathology* / Q000528:radiation effects*; D003287:Contrast Media / Q000008:administration & dosage; D004338:Drug Combinations; D004717:Endometrium / Q000473:pathology / Q000528:radiation effects; D005260:Female; D005500:Follow-Up Studies; D005682:Gadolinium / Q000008:administration & dosage; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement; D008198:Lymph Nodes / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008536:Meglumine / Q000008:administration & dosage; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000473:pathology; D009942:Organometallic Compounds / Q000008:administration & dosage; D004369:Pentetic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives; D011832:Radiation Injuries / Q000209:etiology / Q000473:pathology; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000532:radiotherapy*
D003287:Contrast Media; D004338:Drug Combinations; D009942:Organometallic Compounds; D008536:Meglumine; D004369:Pentetic Acid; D005682:Gadolinium; D019786:Gadolinium DTPA