title: Multimodal endocavitary ultrasound versus MRI and clinical findings in pre- and post-treatment advanced cervical cancer. Preliminary report.
abstract: OBJECTIVE
  The aim of this study was to evaluate the use of pre and post-therapy transrectal and transvaginal ultrasonography (TRUS, TVUS) with contrast enhancement and strain elastography compared with clinical examination and magnetic resonance imaging (MRI) in the assessment of advanced stage cervical cancer.
  
  
  METHODS
  This was a prospective study, carried out over a period of nine months on subjects with advanced-stage cervical cancer (stage >/= IIB). All included patients were examined clinically and underwent abdomino-pelvic contrast enhanced MRI and multimodal US examinations (TRUS with strain elastography and contrast enhanced TVUS) at the time of diagnosis and after radiochemotherapy. Tumor size and staging at TRUS and TVUS was compared with the same data obtained by clinical examination and MRI. Pathology was the golden standard.
  
  
  RESULTS
  Eight patients accomplished the inclusion criteria. In five cases the tumor stage was identical on clinical and MRI examinations. In all cases parametrial infiltration was diagnosed by all pre-treatment examinations. No significant differences were observed in tumor size between clinical, US and MRI exams either at baseline or post-therapy, in native or post-contrast examinations. The size of the tumor evaluated pre-treatment proved to be significantly smaller post-contrast in both US and MRI examinations compared with the native images. Post-therapy, no significant differences were observed on US measured tumor dimensions when comparing native with post-contrast images. Oppositely, significant smaller dimensions were observed on post-contrast MRI compared with native scans.
  
  
  CONCLUSIONS
  TRUS is accurate in the estimation of pre-therapy cervical cancer dimension. The post therapy tumor evaluation is better performed with MRI. The use of intravenous contrast agents on both examinations did not improved the accuracy of tumor evaluation pre or post-therapy.
authors.affiliation: Department of Radiology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Csaba
authors.initials: C
authors.lastname: Csutak
authors.affiliation: "Octavian Fodor" Institute of Gastroenterology and Hepatology, Department of Ultrasonography, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania. rbadea@umfcluj.ro.
authors.forename: Radu
authors.initials: R
authors.lastname: Badea
authors.affiliation: Department of Medical Informatics and Biostatistics, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Sorana D
authors.initials: SD
authors.lastname: Bolboaca
authors.affiliation: "Prof. Dr. Ion Chiricuta" Institute of Oncology, Department of Radiotheraphy, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Claudia
authors.initials: C
authors.lastname: Ordeanu
authors.affiliation: "Prof. Dr. Ion Chiricuta" Institute of Oncology, Department of Radiotheraphy, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Viorica M
authors.initials: VM
authors.lastname: Nagy
authors.affiliation: "Prof. Dr. Ion Chiricuta" Institute of Oncology, Department of Radiotheraphy, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Fekete
authors.affiliation: "Octavian Fodor" Institute of Gastroenterology and Hepatology, Department of Ultrasonography, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Liliana
authors.initials: L
authors.lastname: Chiorean
authors.affiliation: Department of Radiology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Sorin M
authors.initials: SM
authors.lastname: Dudea
mesh_terms: D000328:Adult; D059248:Chemoradiotherapy; D019160:Endosonography / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D010865:Pilot Projects; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*