title: [Invasive cervix carcinoma (pT2b-pT4a). Value of conventional and pharmacokinetic magnetic resonance tomography (MRI) in comparison with extensive cross sections and histopathologic findings].
abstract: OBJECTIVE
  To compare staging of advanced primary cervical carcinoma (pT2b-pT4a) by conventional and pharmacokinetic magnetic resonance imaging (MRI) with the giant cross section specimen and histopathological findings.
  
  
  METHODS
  Seventeen patients with biopsy-proven cancer of the cervix and clinically suspected invasive cancer (FIGO IIB-IVA) were prospectively examined by conventional (T2 and contrast-enhanced T1-weighted spin echo images) and pharmacokinetic MRI. All MRI findings were compared with the giant cross section specimen and histopathology as the standard of reference. For pharmacokinetic MRI, a saturation recovery TurboFLASH sequence was used with a high temporal resolution of 13 s per ten sections. Signal time changes were analyzed using a pharmacokinetic model and the computed parameter values were visualized by color-coded overlay.
  
  
  RESULTS
  Analysis of parametrial invasion on T2-weighted images resulted in an accuracy of 85% and 73% on contrast-enhanced T1-weighted images and on pharmacokinetic MR images respectively. Accuracy of analysis of bladder and/or rectal wall invasion was significantly (P < 0.05) higher on pharmacokinetic MR images (88%) than on T2-weighted images (67%). Contrast-enhanced T1-weighted spin-echo images improved staging accuracy compared with T2-weighted images (76% vs 67%).
  
  
  CONCLUSIONS
  At present, conventional T2-weighted SE images are superior to contrast-enhanced T1-weighted SE and pharmacokinetic MR images in depicting infiltration of the parametrium. However, suspected infiltration of the bladder and/or rectum (pT4a) is diagnosed more accurately on pharmacokinetic images than on conventional MR images.
authors.affiliation: Forschungsschwerpunkt Radiologische Diagnostik und Therapie, Deutsches Krebsforschungszentrum Heidelberg.
authors.forename: H
authors.initials: H
authors.lastname: Hawighorst
authors.forename: P G
authors.initials: PG
authors.lastname: Knapstein
authors.forename: W
authors.initials: W
authors.lastname: Weikel
authors.forename: M V
authors.initials: MV
authors.lastname: Knopp
authors.forename: U
authors.initials: U
authors.lastname: Schaeffer
authors.forename: M
authors.initials: M
authors.lastname: Essig
authors.forename: G
authors.initials: G
authors.lastname: Brix
authors.forename: I
authors.initials: I
authors.lastname: Zuna
authors.forename: S
authors.initials: S
authors.lastname: Schönberg
authors.forename: G
authors.initials: G
authors.lastname: van Kaick
mesh_terms: D000293:Adolescent; D000328:Adult; D001706:Biopsy; D002584:Cervix Uteri / Q000473:pathology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011446:Prospective Studies; D012007:Rectum / Q000473:pathology; D012680:Sensitivity and Specificity; D001743:Urinary Bladder / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology