title: Differentiation between recurrent tumor and benign conditions after treatment of gynecologic pelvic carcinoma: value of dynamic contrast-enhanced subtraction MR imaging.
abstract: OBJECTIVE
  To compare dynamic contrast material-enhanced subtraction and T2-weighted spin-echo (SE) magnetic resonance (MR) imaging in the differentiation of fibrosis from tumor recurrence during the follow-up of treated gynecologic pelvic malignancy.
  
  
  METHODS
  Thirty-four patients (aged 24-82 years) with 18 benign and 35 malignant lesions confirmed by means of surgery (n = 18), biopsy (n = 25), or 18-month follow-up examination (n = 10) underwent dynamic contrast-enhanced subtraction and T2-weighted SE MR imaging. Contrast material enhancement of an abnormal pelvic structure within the first 90 seconds on dynamic contrast-enhanced subtraction images or high signal intensity on T2-weighted SE images was considered indicative of malignancy.
  
  
  RESULTS
  The sensitivity, specificity, accuracy, and positive and negative predictive values were 91%, 67%, 83%, 86%, and 86%, respectively, for dynamic contrast-enhanced subtraction imaging and 91%, 22%, 68%, 70%, and 57%, respectively, for T2-weighted SE imaging. More lesions were correctly classified with dynamic contrast-enhanced subtraction imaging than with T2-weighted SE imaging (P < .01).
  
  
  CONCLUSIONS
  Dynamic contrast-enhanced subtraction imaging is more accurate than T2-weighted SE imaging for differentiating fibrosis from tumor recurrence during the follow-up of treated gynecologic pelvic malignancy. However, use of both sequences is recommended.
authors.affiliation: Department of Radiology, Institut Gustave Roussy, Villejuif, France.
authors.forename: K
authors.initials: K
authors.lastname: Kinkel
authors.forename: M
authors.initials: M
authors.lastname: Ariche
authors.forename: A A
authors.initials: AA
authors.lastname: Tardivon
authors.forename: A
authors.initials: A
authors.lastname: Spatz
authors.forename: D
authors.initials: D
authors.lastname: Castaigne
authors.forename: C
authors.initials: C
authors.lastname: Lhomme
authors.forename: D
authors.initials: D
authors.lastname: Vanel
mesh_terms: D000328:Adult; D000359:Aftercare; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D005355:Fibrosis; D005831:Genital Diseases, Female / Q000473:pathology*; D005833:Genital Neoplasms, Female / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007249:Inflammation; D008279:Magnetic Resonance Imaging / Q000592:standards*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000601:surgery; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013382:Subtraction Technique / Q000592:standards*