Radiology, Vol 204, 55-63, Copyright © 1997 by Radiological Society of North America

ARTICLES

Differentiation between recurrent tumor and benign conditions after treatment of gynecologic pelvic carcinoma: value of dynamic contrast- enhanced subtraction MR imaging

K Kinkel, M Ariche, AA Tardivon, A Spatz, D Castaigne, C Lhomme and D Vanel
Department of Radiology, Institut Gustave Roussy, Villejuif, France.

PURPOSE: 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. MATERIALS AND 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). CONCLUSION: 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.

This article has been cited by other articles:

				E. Sala, S. Wakely, E. Senior, and D. Lomas MRI of Malignant Neoplasms of the Uterine Corpus and Cervix Am. J. Roentgenol., June 1, 2007; 188(6): 1577 - 1587. [Abstract] [Full Text] [PDF]

				J. W. Lee, W. K. Moon, H.-J. Weinmann, S. J. Kim, J. H. Kim, S. H. Park, T. J. Kim, C. J. Yoon, Y. H. Kim, E. Y. Cho, et al. Contrast-enhanced MR Imaging of Postoperative Scars and VX2 Carcinoma in Rabbits: Comparison of Macromolecular Contrast Agent and Gadopentetate Dimeglumine Radiology, October 1, 2003; 229(1): 132 - 139. [Abstract] [Full Text] [PDF]

				Y. Y. Jeong, H. K. Kang, T. W. Chung, J. J. Seo, and J. G. Park Uterine Cervical Carcinoma after Therapy: CT and MR Imaging Findings RadioGraphics, July 1, 2003; 23(4): 969 - 981. [Abstract] [Full Text] [PDF]

				H. Kaur, P. M. Silverman, R. B. Iyer, C. F. Verschraegen, P. J. Eifel, and C. Charnsangavej Diagnosis, Staging, and Surveillance of Cervical Carcinoma Am. J. Roentgenol., June 1, 2003; 180(6): 1621 - 1631. [Full Text] [PDF]

				A. S. Fulcher, S. G. O'Sullivan, E. M. Segreti, and B. D. Kavanagh Recurrent Cervical Carcinoma: Typical and Atypical Manifestations RadioGraphics, October 1, 1999; 19(90001): 103 - 116. [Abstract] [Full Text]