Preoperative CT and MR imaging in determining surgical eligibility for pelvic exenteration

Résumé du document

This study offered the opportunity to compare CT/MR imaging findings with surgical and histological findings in resected specimen. MR images of the pelvis were retrospectively evaluated in the 27 patients.
To be included in the analysis, a CT and/or MRI must have been performed within the three month period before surgery .Since it was difficult on retrospective review of radiology reports to determine whether recurrent disease was simply adherent to or invading adjacent organs and structures, both were considered to be positive involvement in this analysis
MR images were obtained on a Siemens Somatron Sensation 16. CT images were obtained on a Philips Achieva 1,5T XR MRI System.

We compared surgical findings and pathology reports to determine the accuracy of MR findings (to help determine the type of exenteration indicated). Accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were calculated. Cohen's kappa coefficient was used to measure the agreement between anatomopathology and CT / MR imaging (<0 No agreement, 0-0.2 Slight agreement, 0.2-0.4 Fair agreement, 0.4-0.6 Moderate agreement, 0.6-0.8 Substantial agreement, 0.8-1 Almost perfect agreement).

Extraits

[...] Results remain conflicting {Blomqvist This study offered the opportunity to compare CT/MR imaging findings with surgical and histological findings in resected specimen. MR images of the pelvis were retrospectively evaluated in the 27 patients. To be included in the analysis, a CT and/or MRI must have been performed within the three month period before surgery .Since it was difficult on retrospective review of radiology reports to determine whether recurrent disease was simply adherent to or invading adjacent organs and structures, both were considered to be positive involvement in this analysis MR images were obtained on a Siemens Somatron Sensation 16 CT images were obtained on a Philips Achieva 1,5T XR MRI System We compared surgical findings and pathology reports to determine the accuracy of MR findings (to help determine the type of exenteration indicated). [...]

[...] Preoperative CT and MR imaging in determining surgical eligibility for pelvic exenteration Standard MRI on its own has a high accuracy for the diagnosis of pelvic recurrence . MRI has superior sensitivity and specificity compared to CT. The limitation of CT remains its inferior soft tissue contrast as compared to MR{Blomqvist #1598} MRI generally overestimate the presence of tumour within areas of fibrotic scar tissue {Dresen #4}{Barbaro Lange Fibrotic tissue has a low cellular density and a large interstitial space, which results in low signal intensity on high b-value (b1000) diffusion images. [...]