Possibilities and limitations of magnetic resonance imaging in the diagnostics of endocervical adenocarcinomas
- Autores: Antonova I.1, Aksenova S.1, Nudnov N.1,2,3, Kriger A.1
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Afiliações:
- Russian Scientific Center of Roentgenoradiology
- Peoples’ Friendship University of Russia
- Russian Medical Academy of Continuous Professional Education
- Edição: Volume 5, Nº 2 (2024)
- Páginas: 149-166
- Seção: Original Study Articles
- URL: https://journals.rcsi.science/DD/article/view/264829
- DOI: https://doi.org/10.17816/DD585195
- ID: 264829
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Resumo
BACKGROUND: In recent decades, the incidence of cervical adenocarcinomas has increased from 5% to 20%. Endocervical adenocarcinomas are characterized by a more aggressive course and early metastasis. Owing to the difficulties in the cytological diagnosis of cervical adenocarcinoma, early radiation diagnostics and staging subsequently play a key role. Very few studies have examined the use of magnetic resonance imaging in diagnosing cervical adenocarcinomas.
AIM: To determine the diagnostic informativeness of magnetic resonance imaging in the staging of cervical adenocarcinomas according to the T-criterion and assessing the depth of tumor invasion into the stroma of the cervix and clarify the semiotic signs of adenocarcinoma and features of tumor growth in the uterus.
MATERIALS AND METHODS: In total, 123 patients diagnosed with cervical cancer (C53), who underwent diagnosis and treatment between 2020 and 2023, were examined. The examination results of 22 (18%) patients with cervical adenocarcinoma were analyzed. The average patient age was 56 years. A multiparametric magnetic resonance examination of the pelvic organs was performed on 22 patients using tomographs with a magnetic field strength of 1.5 T. Moreover, 14 (64%) patients underwent surgery including extirpation of the uterus and appendages with pelvic lymphadenectomy. The information value of magnetic resonance imaging was evaluated in 11 patients, whose first stage was surgical treatment.
RESULTS: In this study, cervical adenocarcinoma was detected in 18% among all cases of cervical cancer. The information value of magnetic resonance imaging in assessing the local prevalence of endocervical adenocarcinoma according to the T-criterion was as follows (main value with the corresponding 95% confidence interval): sensitivity, 77.78% (39.99%–97.19%); specificity, 50.00% (1.26%–98.74%); positive predictive value, 87.50% (62.64%–96.69%); negative predictive value, 33.33% (7.30%–76.04%); and accuracy, 72.73% (39.03%–93.98%). The information value of magnetic resonance imaging in assessing the depth of tumor invasion into the cervical stroma was as follows: odds ratio, 3.500 (0.145%–84.694%); sensitivity, 85.7% (0.757%–0.993%); specificity, 33.3% (0.018%–0.0648%); positive predictive value, 75% (0.673%–0.883%); negative predictive value, 50% (0.027%–0.972%).
CONCLUSIONS: The results of this study showed that magnetic resonance imaging is a good tool with high diagnostic informativeness in detecting endocervical cervical adenocarcinoma. The four macrostructures of tumor growth in endocervical adenocarcinoma identified during magnetic resonance imaging data analysis indicate locally aggressive tumor growth and a high frequency of endometrial dropouts. This finding will allow radiologists to structure a descriptive picture, including the verified cervical adenocarcinoma, to enhance methods of developing a treatment plan for the patient.
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##article.viewOnOriginalSite##Sobre autores
Irina Antonova
Russian Scientific Center of Roentgenoradiology
Email: Iran24@yandex.ru
ORCID ID: 0000-0003-2668-2110
Código SPIN: 6247-3917
MD, Dr. Sci. (Medicine)
Rússia, MoscowSvetlana Aksenova
Russian Scientific Center of Roentgenoradiology
Autor responsável pela correspondência
Email: fabella@mail.ru
ORCID ID: 0000-0003-2552-5754
Código SPIN: 4858-4627
MD, Cand. Sci. (Medicine)
Rússia, MoscowNikolay Nudnov
Russian Scientific Center of Roentgenoradiology; Peoples’ Friendship University of Russia; Russian Medical Academy of Continuous Professional Education
Email: nvnudnov@rncrr.ru
ORCID ID: 0000-0001-5994-0468
Código SPIN: 3018-2527
MD, Dr. Sci. (Medicine), Professor
Rússia, Moscow; Moscow; MoscowAnna Kriger
Russian Scientific Center of Roentgenoradiology
Email: dr.akriger@gmail.com
ORCID ID: 0000-0001-6823-2658
Código SPIN: 2338-6164
Rússia, Moscow
Bibliografia
- Global health estimates: Leading causes of death. Cause-specific mortality, 2000–2019. World Health Organization; c2024. Available from: https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates/ghe-leading-causes-of-death
- Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–249. doi: 10.3322/caac.21660
- Kaprin AD, Starinskii VV, Shakhzadova AO, editors. State of oncological care for the Russian population in 2021. Moscow: MNIOI im. P.A. Gertsena — filial FGBU “NMITs radiologii” Minzdrava Rossii; 2022. (In Russ).
- Chan ZF, Zhi KZ. Prevalence and attribution of high-risk HPV in different histological types of cervical cancer. Zhonghua Fu Chan Ke Za Zhi. 2019;54(5):293–300. doi: 10.3760/cma.j.issn.0529-567x.2019.05.002
- Li N, Franceschi S, Howell-Jones R, et al. Human papillomavirus type distribution in 30,848 invasive cervical cancers worldwide: Variation by geographical region, histological type and year of publication. Int J Cancer. 2011;128(4):927–935. doi: 10.1002/ijc.25396
- Nicolás I, Marimon L, Barnadas E, et al. HPV-negative tumors of the uterine cervix. Mod Pathol. 2019;32(8):1189–1196. doi: 10.1038/s41379-019-0249-1
- NCCN guidelines panel. Cervical Cancer. Version 1.2021 PA: National Comprehensive Cancer Network; c2024. Available from: https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1426
- Cervical cancer. Clinical guidelines. ID 537. Approved by the Scientific and Practical Council of the Ministry of Health of the Russian Federation. 2020. Available from: https://cr.minzdrav.gov.ru/recomend/537_1 (In Russ).
- Stolnicu S, Barsan I, Hoang L, et al. International Endocervical Adenocarcinoma Criteria and Classification (IECC): A New Pathogenetic Classification for Invasive Adenocarcinomas of the Endocervix. Am J Surg Pathol. 2018;42(2):214–226. doi: 10.1097/PAS.0000000000000986
- Grigoruk OG, Moskvina TA, Tsoy DA, et al. Endocervical adenocarcinomas. Cytological, histological, and molecular diagnostics. Tumors of female reproductive system. 2022;18(2):109–118. doi: 10.17650/1994-4098-2022-18-2-109-118
- World Health Organization. Female Genital Tumors. In: WHO Classification of Tumours, 5th Edition, Volume 4. International Agency for Research on Cancer; 2020.
- Islami F, Fedewa SA, Jemal A. Trends in cervical cancer incidence rates byage, race/ethnicity, histological subtype, and stage at diagnosis in the United States. Preventive Medicine. 2019;123:316–323. doi: 10.1016/j.ypmed.2019.04.010
- Hu J, Zheng P, Zhu L. Comparison of clinical pathological characteristics in ovarian preserving patients with stage IB1 cervical adenocarcinoma and squamous cell carcinoma. Journal of Peking University (Health Sciences). 2016;48(5):783–787. doi: 10.3969/j.issn.1671-167X.2016.05.006
- Hu K, Wang W, Liu X, et al. Comparison of treatment outcomes between squamous cell carcinoma and adenocarcinoma of cervix after definitive radiotherapy or concurrent chemoradiotherapy. Radiat Oncol. 2018;13(1):249. doi: 10.1186/s13014-018-1197-5
- Fan Y, Wang M, Mu Y, et al. Ovarian metastasis in women with cervical carcinoma in stages IA to IIB. Medicine (Baltimore). 2020;99(31):e21146. doi: 10.1097/MD.0000000000021146
- Bhatla N, Aoki D, Sharma DN, et al. Cancer of the cervix uteri: 2021 update. Int J Gynaecol Obstet. 2021;155 Suppl. 1:28–44. doi: 10.1002/ijgo.13865
- Stewart CJR, Crum CP, McCluggage WG, et al. Guidelines to Aid in the Distinction of Endometrial and Endocervical Carcinomas, and the Distinction of Independent Primary Carcinomas of the Endometrium and Adnexa From Metastatic Spread Between These and Other Sites. Int J Gynecol Pathol. 2019;38 Suppl. 1(1 Suppl. 1):S75–S92. doi: 10.1097/PGP.0000000000000553
- Song J, Im S, Lee SH, Jang HJ. Deep Learning-Based Classification of Uterine Cervical and Endometrial Cancer Subtypes from Whole-Slide Histopathology Images. Diagnostics (Basel). 2022;12(11):2623. doi: 10.3390/diagnostics12112623
- Woo S, Atun R, Ward ZJ, et al. Diagnostic performance of conventional and advanced imaging modalities for assessing newly diagnosed cervical cancer: systematic review and meta-analysis. Eur Radiol. 2020;30(10):5560–5577. doi: 10.1007/s00330-020-06909-3
- Merz J, Bossart M, Bamberg F, et al. Revised FIGO Staging for Cervical Cancer — A New Role for MRI. Rofo. 2020;192(10):937–944. doi: 10.1055/a-1198-5729
- Rubtsova NA, Novikova EG, Sinitsyn VE. MRI opportunities in cervical cancer local staging preoperative evaluation. Obstetrics, Gynecology and Reproduction. 2012;6(3):6–13. EDN: PUVJZT
- Balcacer P, Shergill A, Litkouhi B. MRI of cervical cancer with a surgical perspective: staging, prognostic implications and pitfalls. Abdom Radiol (NY). 2019;44(7):2557–2571. doi: 10.1007/s00261-019-01984-7
- Woo S, Suh CH, Kim SY, et al. 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. European Radiology. 2018;28(2):530–541. doi: 10.1007/s00330-017-4958-x
- Alt CD, Bharwani N, Danza FM, et al. ESUR Quick Guide to Female Pelvis Imaging. ESUR, 2019. Available from: https://www.researchgate.net/publication/334725882_ESUR_Quick_Guide_to_Female_Pelvis_Imaging
- Castanon A, Landy R, Sasieni PD. Is cervical screening preventing adenocarcinoma and adenosquamous carcinoma of the cervix. Int J Cancer. 2016;139(5):1040–1045 doi: 10.1002/ijc.30152
- Suh DH, Ha HI, Lee YJ, et al. Incidence and treatment outcomes of uterine cervical cancer in Korea 1999–2018 from the national cancer registry. J Gynecol Oncol. 2023;34(2):e39. doi: 10.3802/jgo.2023.34.e39
- Miyamoto T, Kobara H, Shiozawa T. Biology and management of lobular endocervical glandular hyperplasia. J Obstet Gynaecol Res. 2022;48(12):3056–3067. doi: 10.1111/jog.15441
- Kerwin CM, Markese M, Moroney MR, et al. Adenocarcinoma of the uterine cervix, gastric-type (GAS): a review of the literature focused on pathology and multimodality imaging. Abdom Radiol (NY). 2023;48(2):713–723. doi: 10.1007/s00261-022-03724-w
- Marnitz S, Tsunoda AT, Martus P, et al. Surgical versus clinical staging prior to primary chemoradiation in patients with cervical cancer FIGO stages IIB–IVA: oncologic results of a prospective randomized international multicenter (Uterus-11) intergroup study. Int J Gynecol Cancer. 2020;30(12):1855–1861. doi: 10.1136/ijgc-2020-001973
- Akhavan S, Mousavi A, Sheikh Hassani S, et al. Evaluation of Cervical Cancer Staging Based on Magnetic Resonance Imaging in Comparison with Surgical Staging. Int J Cancer Manag. 2023;16(1):e126966. doi: 10.5812/ijcm-126966
- Trukhacheva NG, Frolova IG, Kolomiets LA, et al. Assessment of the extent of cervical cancer spread using magnetic resonance imaging. Siberian journal of oncology. 2015;(2):64–70. EDN: TSLSAD
- Horn LC, Höhn AK, Stark S, et al. Endocervical adenocarcinoma in situ (AIS) with ovarian and pulmonary involvement: report of a case and review of the literature suggesting a “seed and soil hypothesis”. J Cancer Res Clin Oncol. 2019;145(8):2061–2069. doi: 10.1007/s00432-019-02966-4
- Mao L, Zhang X, Chen T, et al. High-resolution reduced field-of-view diffusion-weighted magnetic resonance imaging in the diagnosis of cervical cancer. Quant Imaging Med Surg. 2023;13(6):3464–3476. doi: 10.21037/qims-22-579
- Kuang F, Ren J, Zhong Q, et al. The value of apparent diffusion coefficient in the assessment of cervical cancer. Eur Radiol. 2013;23(4):1050–1058. doi: 10.1007/s00330-012-2681-1
- Wang M, Perucho JAU, Chan Q. Diffusion Kurtosis Imaging in the Assessment of Cervical Carcinoma. Acad Radiol. 2020;27(5):E94–E101. doi: 10.1016/j.acra.2019.06.022
- Monist M, Lewkowicz D, Piętak P, et al. Synchronously occurring endometrioid carcinomas of the uterine corpus and uterine cervix preceded by different precancerous lesions: A case study and a literature review. Pathol Res Pract. 2023;245:154452. doi: 10.1016/j.prp.2023.154452
- Lin YC, Lin G, Chen YR, et al. Role of magnetic resonance imaging and apparent diffusion coefficient at 3T in distinguishing between adenocarcinoma of the uterine cervix and endometrium. Chang Gung Med J. 2011;34(1):93–100.
- Gui B, Lupinelli M, Russo L, et al. MRI in uterine cancers with uncertain origin: Endometrial or cervical? Radiological point of view with review of the literature. European journal of radiology. 2022;153:110357. doi: 10.1016/j.ejrad.2022.110357
- Tarachkova EV, Shorikov MA, Panov VO, et al. Possibilities of multiparametric MRI in the differential diagnosis of histological types of cervical cancer in the preoperative period. Tumors of female reproductive system. 2016;12(2):60–69. doi: 10.17650/1994-4098-2016-12-2-60-69
- Yemelyanova A, Vang R, Seidman JD, Gravitt PE, Ronnett BM. Endocervical adenocarcinomas with prominent endometrial or endomyometrial involvement simulating primary endometrial carcinomas: utility of HPV DNA detection and immunohistochemical expression of p16 and hormone receptors to confirm the cervical origin of the corpus tumor. Am J Surg Pathol. 2009;33(6):914–924. doi: 10.1097/PAS.0b013e3181971fdd
- Jain P, Aggarwal A, Ghasi RG, et al. Role of MRI in diagnosing the primary site of origin in indeterminate cases of uterocervical carcinomas: a systematic review and meta-analysis. Br J Radiol. 2022;95(1129):20210428. doi: 10.1259/bjr.20210428