Top

19-07-2017 | Cervical cancer | Article

Magnetic resonance imaging for detection of parametrial invasion in cervical cancer: An updated systematic review and meta-analysis of the literature between 2012 and 2016

Journal: European Radiology

Authors: Sungmin Woo, Chong Hyun Suh, Sang Youn Kim, Jeong Yeon Cho, Seung Hyup Kim

Publisher: Springer Berlin Heidelberg

Abstract

Objective

To review the diagnostic performance of MRI for detection of parametrial invasion (PMI) in cervical cancer patients.

Methods

MEDLINE and EMBASE databases were searched for studies providing diagnostic performance of MRI for detecting PMI in patients with cervical cancer. Studies published between 2012 and 2016 using surgico-pathological results as reference standard were included. Study quality was evaluated using QUADAS-2. Sensitivity and specificity of all studies were calculated. Results were pooled and plotted in a hierarchical summary receiver operating characteristic plot. Meta-regression and subgroup analyses were performed.

Results

Fourteen studies (1,028 patients) were included. Study quality was generally moderate. Pooled sensitivity was 0.76 (95% CI 0.67–0.84) and specificity was 0.94 (95% CI 0.91–0.95). The possibility of heterogeneity was considered low: Cochran’s Q-test (p = 0.471), Tau² (0.240), Higgins I² (0%). With meta-regression analysis, magnet strength, use of DWI, and antispasmodic drugs were significant factors affecting heterogeneity (p < 0.01). Subgroup analysis for studies solely using radical hysterectomy as reference standard yielded pooled sensitivity and specificity of 0.73 (95% CI 0.60–0.83) and 0.93 (95% CI 0.90–0.95), respectively.

Conclusions

MRI shows good performance for detection of PMI in cervical cancer. Using 3-T scanners and DWI may improve diagnostic performance.

Key Points

• MRI shows good performance for detection of parametrial invasion in cervical cancer.

• Subgroup of studies using only radical hysterectomy showed consistent results.

• Using 3-Tesla scanners and diffusion-weighted imaging may improve diagnostic performance.

Siegel R, Naishadham D, Jemal A (2012) Cancer statistics, 2012. CA Cancer J Clin 62:10–29CrossRefPubMed

Landoni F, Bocciolone L, Perego P, Maneo A, Bratina G, Mangioni C (1995) Cancer of the cervix, FIGO stages IB and IIA: patterns of local growth and paracervical extension. Int J Gynecol Cancer 5:329–334CrossRefPubMed

Peters WA 3rd, Liu PY, Barrett RJ 2nd et al (2000) Concurrent chemotherapy and pelvic radiation therapy compared with pelvic radiation therapy alone as adjuvant therapy after radical surgery in high-risk early-stage cancer of the cervix. J Clin Oncol 18:1606–1613CrossRefPubMed

Pecorelli S, Benedet JL, Creasman WT, Shepherd JH (1999) FIGO staging of gynecologic cancer. 1994–1997 FIGO Committee on Gynecologic Oncology. International Federation of Gynecology and Obstetrics. Int J Gynaecol Obstet 65:243–249CrossRefPubMed

Motta-Ramirez GA, Remer EM, Herts BR, Gill IS, Hamrahian AH (2005) Comparison of CT findings in symptomatic and incidentally discovered pheochromocytomas. AJR Am J Roentgenol 185:684–688CrossRefPubMed

Pecorelli S, Zigliani L, Odicino F (2009) Revised FIGO staging for carcinoma of the cervix. Int J Gynaecol Obstet 105:107–108CrossRefPubMed

Bipat S, Glas AS, van der Velden J, Zwinderman AH, Bossuyt PM, Stoker J (2003) Computed tomography and magnetic resonance imaging in staging of uterine cervical carcinoma: a systematic review. Gynecol Oncol 91:59–66CrossRefPubMed

Thomeer MG, Gerestein C, Spronk S, van Doorn HC, van der Ham E, Hunink MG (2013) Clinical examination versus magnetic resonance imaging in the pretreatment staging of cervical carcinoma: systematic review and meta-analysis. Eur Radiol 23:2005–2018CrossRefPubMed

Hori M, Kim T, Onishi H et al (2011) Uterine tumors: comparison of 3D versus 2D T2-weighted turbo spin-echo MR imaging at 3.0 T: initial experience. Radiology 258:154–163CrossRefPubMed

10.

Liberati A, Altman DG, Tetzlaff J et al (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol 62:e1–e34CrossRefPubMed

11.

Whiting P, Rutjes AW, Reitsma JB, Bossuyt PM, Kleijnen J (2003) The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol 3:25CrossRefPubMedPubMedCentral

12.

Suh CH, Park SH (2016) Successful publication of systematic review and meta-analysis of studies evaluating diagnostic test accuracy. Korean J Radiol 17:5–6CrossRefPubMedPubMedCentral

13.

Deeks JJ, Macaskill P, Irwig L (2005) The performance of tests of publication bias and other sample size effects in systematic reviews of diagnostic test accuracy was assessed. J Clin Epidemiol 58:882–893CrossRefPubMed

14.

Higgins J, Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0. The Cochrane Collaboration. http://handbook.cochrane.org/chapter_9/9_5_2_identifying_and_measuring_heterogeneity.htm. Updated March 2011. Accessed January 3, 2017

15.

McInnes MDF, Bossuyt PMM (2015) Pitfalls of systematic reviews and meta-analyses in imaging research. Radiology 277:13–21CrossRefPubMed

16.

Bleker SM, Bipat S, Spijkerboer AM, van der Velden J, Stoker J, Kenter GG (2013) The negative predictive value of clinical examination with or without anesthesia versus magnetic resonance imaging for parametrial infiltration in cervical cancer stages IB1 to IIA. Int J Gynecol Cancer 23:193–198CrossRefPubMed

17.

Bourgioti C, Chatoupis K, Rodolakis A et al (2016) Incremental prognostic value of MRI in the staging of early cervical cancer: a prospective study and review of the literature. Clin Imaging 40:72–78CrossRefPubMed

18.

Downey K, Attygalle AD, Morgan VA et al (2016) Comparison of optimised endovaginal vs external array coil T2-weighted and diffusion-weighted imaging techniques for detecting suspected early stage (IA/IB1) uterine cervical cancer. Eur Radiol 26:941–950CrossRefPubMed

19.

Epstein E, Testa A, Gaurilcikas A et al (2013) Early-stage cervical cancer: tumor delineation by magnetic resonance imaging and ultrasound - a European multicenter trial. Gynecol Oncol 128:449–453CrossRefPubMed

20.

Kitajima K, Suenaga Y, Ueno Y et al (2014) Fusion of PET and MRI for staging of uterine cervical cancer: comparison with contrast-enhanced (18)F-FDG PET/CT and pelvic MRI. Clin Imaging 38:464–469CrossRefPubMed

21.

Kong TW, Kim J, Son JH et al (2016) Preoperative nomogram for prediction of microscopic parametrial infiltration in patients with FIGO stage IB cervical cancer treated with radical hysterectomy. Gynecol Oncol 142:109–114CrossRefPubMed

22.

Kraljevic Z, Viskovic K, Ledinsky M et al (2013) Primary uterine cervical cancer: correlation of preoperative magnetic resonance imaging and clinical staging (FIGO) with histopathology findings. Coll Antropol 37:561–568PubMed

23.

Lee JY, Youm J, Kim TH et al (2014) Preoperative MRI criteria for trials on less radical surgery in Stage IB1 cervical cancer. Gynecol Oncol 134:47–51CrossRefPubMed

24.

Moloney F, Ryan D, Twomey M, Hewitt M, Barry J (2016) Comparison of MRI and high-resolution transvaginal sonography for the local staging of cervical cancer. J Clin Ultrasound 44:78–84CrossRefPubMed

25.

Park JJ, Kim CK, Park SY, Park BK (2015) Parametrial invasion in cervical cancer: fused T2-weighted imaging and high-b-value diffusion-weighted imaging with background body signal suppression at 3 T. Radiology 274:734–741CrossRefPubMed

26.

Shin YR, Rha SE, Choi BG, Oh SN, Park MY, Byun JY (2013) Uterine cervical carcinoma: a comparison of two- and three-dimensional T2-weighted turbo spin-echo MR imaging at 3.0 T for image quality and local-regional staging. Eur Radiol 23:1150–1157CrossRefPubMed

27.

Shweel MA, Abdel-Gawad EA, Abdel-Gawad EA, Abdelghany HS, Abdel-Rahman AM, Ibrahim EM (2012) Uterine cervical malignancy: diagnostic accuracy of MRI with histopathologic correlation. J Clin Imaging Sci 2:42CrossRefPubMedPubMedCentral

28.

Wei C, Dong JN, Li NY, Wei SH, Gao F (2013) Value of 3.0T MR LAVA-Flex multi-phase enhancement techniques combined with DWI in preoperative evaluation and staging of cervical cancer. Chin J Med Imag Technol 29:2015–2019

29.

Yu X, Lin M, Ye F et al (2015) Comparison of contrast-enhanced isotropic 3D-GRE-T1WI sequence versus conventional non-isotropic sequence on preoperative staging of cervical cancer. PLoS One 10, e0122053CrossRefPubMedPubMedCentral

30.

Lee J, Kim KW, Choi SH, Huh J, Park SH (2015) Systematic review and meta-analysis of studies evaluating diagnostic test accuracy: A practical review for clinical researchers–Part II. Statistical Methods of Meta-Analysis. Korean J Radiol 16:1188–1196CrossRefPubMedPubMedCentral

31.

Hori M, Kim T, Murakami T et al (2009) Uterine cervical carcinoma: preoperative staging with 3.0-T MR imaging: comparison with 1.5-T MR imaging. Radiology 251:96–104CrossRefPubMed

32.

Naganawa S, Sato C, Kumada H, Ishigaki T, Miura S, Takizawa O (2005) Apparent diffusion coefficient in cervical cancer of the uterus: comparison with the normal uterine cervix. Eur Radiol 15:71–78CrossRefPubMed

33.

Balleyguier C, Sala E, Da Cunha T et al (2011) Staging of uterine cervical cancer with MRI: guidelines of the European Society of Urogenital Radiology. Eur Radiol 21:1102–1110CrossRefPubMed

34.

Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174CrossRefPubMed