METHOD

Dynamic contrast-enhanced MRI in determining histological type of cervical cancer

Tarachkova EV1, Shorikov MA1,2, Panov VO1,2, Kuznetsov VV2, Tyurin IE1,2, Shimanovsky NL3
About authors

1 Department of Roentgenology and Radiology,
Russian Medical Academy of Postgraduate Education, Moscow, Russia

2 N. N. Blokhin Russian Cancer Research Center, Moscow, Russia

3 P. V. Sergeev Molecular Pharmacology and Radiobiology Department, Biomedical Faculty,
Pirogov Russian National Research Medical University, Moscow, Russia

Correspondence should be addressed: Elena Tarachkova
ul. Barrikadnaya, d. 2/1, str. 1, Moscow, Russia, 123995; ur.xednay@dikrotcod

Received: 2016-08-10 Accepted: 2016-08-18 Published online: 2017-01-05
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Knowing the histology of cervical cancer (squamos cell carcinoma or adenocarcinoma) is important in deciding on the best treatment plan. We have studied the role of dynamic contrast-enhanced magnetic resonance imaging in the differential diagnosis of cervical cancer. We examined 90 patients between 23 and 78 years of age (mean age was 43.5 years) with histologically distinctive stage IIb–IVb cervical cancers. Scanning was performed on Magnetom Espree 1.5T and Magnetom Skyra 3.0T scanners (Siemens, Germany) using gadobutrol (Gadavist by Bayer, Germany). On T1-weighted images, signal intensity and its rate of change were significantly higher for adenocarcinomas compared to squamos cell carcinomas (p <0.04) from the 20th second after gadobutrol had been delivered to the tumor. With squamos cell carcinomas, the time-intensity curve (showing the dependence of signal intensity on the time elapsed after gadobutrol had been delivered to the tumor) had two phases: a short phase of a relatively slow accumulation of the contrast agent with the subsequent plateau or even signal intensity reduction. The pattern of gadobutrol accumulation allows differentiating between histological types of tumors. Based on the resulting curves, a pharmacokinetic model can be described for each tumor type. Postcontrast images are useful in determining tumor differentiation grade. Specifically, the signal from a well-differentiated adenocarcinoma is the most inhomogeneous one (p <0.03). The method described in this work does not imply that histological analysis is unnecessary and can be recommended as a supplementary diagnostic tool.

Keywords: cervical cancer, magnetic resonance imaging, contrast enhancement, gadobutrol, adenocarcinoma, squamos cell carcinoma, differential diagnosis

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