Department of Obstetrics and Gynecology, Saitama Medical Center, The Jichi Medical University, Saitama, Japan.
Department of Obstetrics and Gynecology, Saitama Medical Center, The Jichi Medical University, Saitama, Japan
In Vivo. 2023 Jul-Aug;37(4):1786-1789. doi: 10.21873/invivo.13267.
BACKGROUND/AIM: Diagnosis of cervical cancer with tumor diameter <2 cm using magnetic resonance imaging alone has not been investigated. Moreover, whether tumor volume can be used for diagnosing the true tumor diameter remains unknown. Here, we investigated the utility of early cervical cancer volume index in diagnosing cervical cancer with a tumor diameter of <2 cm, which can be treated using more conservative surgery.
This single-center retrospective study analyzed women who underwent radical hysterectomy for cervical cancer with a tumor diameter of <2 cm and clinical stages IA2, IB1, IB2, IB3, and IIA1 at our institute between January 2009 and April 2022. The volume index, defined as the product of the maximum longitudinal diameter along the uterine axis, maximum anteroposterior diameter (thickness) on a sagittal section image, and maximum horizontal diameter on a horizontal section image, was evaluated using either T2-weighted magnetic resonance imaging or gadolinium-enhanced T1-weighted imaging. The receiver operating characteristic curve for the volume index was also calculated.
The sensitivity and specificity of magnetic resonance imaging for measuring the tumor diameter were 0.92 and 0.84, respectively. The calculated cut-off value was 2.60, whereas the volume index area under the curve was 0.955, with a sensitivity of 0.92 and specificity of 0.93.
Considering the specificity and low incidence of false-negative results, the volume index can be used for preoperative diagnosis of pT1B1 cervical cancer, which can be treated with more conservative surgery.
背景/目的:单独使用磁共振成像诊断直径 <2 cm 的宫颈癌尚未得到研究。此外,肿瘤体积是否可用于诊断真实肿瘤直径仍不清楚。在这里,我们研究了早期宫颈癌体积指数在诊断直径 <2 cm、可采用更保守手术治疗的早期宫颈癌中的应用。
本单中心回顾性研究分析了 2009 年 1 月至 2022 年 4 月在我院接受根治性子宫切除术治疗、肿瘤直径 <2 cm、临床分期为 IA2、IB1、IB2、IB3 和 IIA1 的宫颈癌患者。体积指数定义为沿子宫轴的最大纵向直径、矢状位图像上的最大前后径(厚度)和水平位图像上的最大水平直径的乘积,使用 T2 加权磁共振成像或钆增强 T1 加权成像进行评估。还计算了体积指数的受试者工作特征曲线。
磁共振成像测量肿瘤直径的灵敏度和特异性分别为 0.92 和 0.84。计算出的截止值为 2.60,而体积指数曲线下面积为 0.955,灵敏度为 0.92,特异性为 0.93。
考虑到特异性和假阴性结果的发生率低,体积指数可用于术前诊断可采用更保守手术治疗的 pT1B1 宫颈癌。