1. Adams TS, Cuello MA. Cancer of the vagina. International Journal of Gynaecology & Obstetrics. 143 Suppl 2:14-21, 2018 Oct. |
Review/Other-Dx |
N/A |
To review the diagnosis of vaginal cancer in relation to HIV prevalence. |
No results stated in abstract. |
4 |
2. Di Donato V, Bellati F, Fischetti M, Plotti F, Perniola G, Panici PB. Vaginal cancer. [Review]. Critical Reviews in Oncology-Hematology. 81(3):286-95, 2012 Mar. |
Review/Other-Tx |
N/A |
To report the current results achieved by different therapeutic strategies for vaginal cancer. |
No results stated in abstract. |
4 |
3. Gadducci A, Fabrini MG, Lanfredini N, Sergiampietri C. Squamous cell carcinoma of the vagina: natural history, treatment modalities and prognostic factors. [Review]. Crit Rev Oncol Hematol. 93(3):211-24, 2015 Mar. |
Review/Other-Dx |
N/A |
To review the natural history, treatment and prognostic factors of squamous cell carcinoma. |
No results stated in abstract. |
4 |
4. Rajaram S, Maheshwari A, Srivastava A. Staging for vaginal cancer. [Review]. Best Practice & Research in Clinical Obstetrics & Gynaecology. 29(6):822-32, 2015 Aug. |
Review/Other-Dx |
N/A |
To review the incidence and staging of vaginal cancer. |
No results stated in abstract. |
4 |
5. Lee LJ, Jhingran A, Kidd E, et al. Acr appropriateness Criteria management of vaginal cancer. [Review]. Oncology (Williston Park). 27(11):1166-73, 2013 Nov. |
Review/Other-Dx |
N/A |
This article represents the consensus opinion of an expert panel and may be used to inform clinical recommendations in vaginal cancer management. |
No results stated in abstract. |
4 |
6. Tan Mbbs Mrcp Frcr Md LT, Tanderup Ph DK, Kirisits Ph DC, et al. Image-guided Adaptive Radiotherapy in Cervical Cancer. Semin Radiat Oncol 2019;29:284-98. |
Review/Other-Dx |
N/A |
To review the conceptual, methodological, and technical innovations underpinning strategies for adaptive target volume selection and risk-adapted dose prescription in cervical cancer. |
No results stated in abstract. |
4 |
7. Papadopoulou I, Stewart V, Barwick TD, et al. Post-Radiation Therapy Imaging Appearances in Cervical Carcinoma. [Review]. Radiographics. 36(2):538-53, 2016 Mar-Apr. |
Review/Other-Tx |
N/A |
To review the post radiation therapy effects on cervical carcinome. |
No results stated in abstract. |
4 |
8. Huertas A, Dumas I, Escande A, et al. Image-guided adaptive brachytherapy in primary vaginal cancers: A monocentric experience. Brachytherapy. 17(3):571-579, 2018 May - Jun. |
Observational-Tx |
27 patients |
To report the experience of using image-guided adaptive brachytherapy (IGABT) for primary vaginal cancer. |
MRI was used for brachytherapy guidance in 82% of the cases. An interstitial component was used in 59% of the cases. The D90 CTVBT and D90 CTVi were 73.1 +/- 12.8 Gy and 66.6 +/- 6.7 Gy, respectively. After a median followup of 40.1 months, nine recurrences in 8 patients were observed of which four were local. Local relapses occurred within the CTVBT. Three-year local control and disease-free rates were 82% and 65%, respectively. At 2 years, the Grade 2-4 gastrointestinal or urinary morbidity accrual rate was 9%. Twelve patients experienced late sexual morbidity, including three patients with Grade 3 stenosis. |
2 |
9. Manuel MM, Cho LP, Catalano PJ, et al. Outcomes with image-based interstitial brachytherapy for vaginal cancer. Radiotherapy & Oncology. 120(3):486-492, 2016 09. |
Observational-Tx |
72 patients |
To compare clinical outcomes of image-based versus non-image-based interstitial brachytherapy (IBBT) for vaginal cancer. |
Median age was 66 and median follow-up time was 24months. Median cumulative EQD2 dose was 80.8Gy in the non-IBBT group and 77Gy in the IBBT group. For non-IBBT versus IBBT, the 2-year KM LC was 71% vs. 93% (p=0.03); DFI was 54% vs. 86% (p=0.04); and OS 52% vs. 82% (p=0.35). On multivariate analysis, IBBT was associated with better DFI (HR 0.24, 95% CI 0.07-0.73). Having any 2 or more of chemotherapy, high-dose-rate (HDR) BT or IBBT (temporally correlated variables) significantly reduced risk of relapse (HR=0.33, 95% CI=0.13-0.83), compared to having none of these factors. |
2 |
10. Bhatla N, Berek JS, Cuello Fredes M, et al. Revised FIGO staging for carcinoma of the cervix uteri. Int J Gynaecol Obstet 2019;145:129-35. |
Review/Other-Dx |
N/A |
To revise FIGO staging of carcinoma of the cervix uteri, allowing incorporation of imaging and/or pathological findings, and clinical assessment of tumor size and disease extent. |
In stage I, revision of the definition of microinvasion and lesion size as follows. Stage IA: lateral extension measurement is removed; stage IB has three subgroups-stage IB1: invasive carcinomas >/=5 mm and <2 cm in greatest diameter; stage IB2: tumors 2-4 cm; stage IB3: tumors >/=4 cm. Imaging or pathology findings may be used to assess retroperitoneal lymph nodes; if metastatic, the case is assigned stage IIIC; if only pelvic lymph nodes, the case is assigned stage IIIC1; if para-aortic nodes are involved, the case is assigned stage IIIC2. Notations 'r' and 'p' will indicate the method used to derive the stage-i.e., imaging or pathology, respectively-and should be recorded. Routine investigations and other methods (e.g., examination under anesthesia, cystoscopy, proctoscopy, etc.) are not mandatory and are to be recommended based on clinical findings and standard of care. |
4 |
11. Guerri S, Perrone AM, Buwenge M, et al. Definitive Radiotherapy in Invasive Vaginal Carcinoma: A Systematic Review. Oncologist 2019;24:132-41. |
Meta-analysis |
13 studies |
To systematically review the recent literature on the role of definitive radiotherapy (RT) in the management of vaginal cancer (VC) and presents comprehensive data on clinical outcomes and toxicity. |
All studies had a retrospective design. Overall, 793 patients (median, 45; range, 26-138) were included. A high heterogeneity was found across studies in terms of RT techniques, assessment criteria, and reported outcomes. The majority of the patients were treated with a combination of external beam RT and brachytherapy (74.2%). Acute and late grade >/=3 toxicity rates ranged from 0.0% to 24.4% (median, 8.7%) and from 0.0% to 22.5% (median, 12.8%), respectively. The 5-year local control rates ranged between 39% and 79%. The 5-year overall survival ranged between 34% and 71.0% (median, 63.5%). Early stage of the disease (International Federation of Gynecology and Obstetrics stages I-II vs. III-IV), small tumor size (<4 cm), previous hysterectomy, high pretreatment/treatment hemoglobin levels (>/=12/12.5 mg/dL), and patients' age <70 or <64 years were correlated with better clinical outcomes. |
Good |
12. Vargo JA, Kim H, Choi S, et al. Extended field intensity modulated radiation therapy with concomitant boost for lymph node-positive cervical cancer: analysis of regional control and recurrence patterns in the positron emission tomography/computed tomography era. Int J Radiat Oncol Biol Phys. 90(5):1091-8, 2014 Dec 01. |
Observational-Dx |
61 patients |
To assess regional control rates and recurrence patterns of cervical cancer after being treated with PET-positive nodes with extended field intensity modulated radiation therapy. |
Complete clinical and imaging response at the first follow-up visit was seen in 77% of patients. At a mean follow-up time of 29 months (range, 3-116 months), 8 patients experienced recurrence. The sites of persistent/recurrent disease were as follows: cervix 10 (16.3%), regional nodes 3 (4.9%), and distant 14 (23%). The rate of para-aortic failure in patients with pelvic-only nodes was 2.5%. There were no significant differences in recurrence patterns by the number/location of nodes, largest node size, or maximum node standardized uptake value. The rate of late grade 3+ adverse events was 4%. |
4 |
13. Gee MS, Atri M, Bandos AI, Mannel RS, Gold MA, Lee SI. Identification of Distant Metastatic Disease in Uterine Cervical and Endometrial Cancers with FDG PET/CT: Analysis from the ACRIN 6671/GOG 0233 Multicenter Trial. Radiology 2018;287:176-84. |
Observational-Dx |
153 cervical cancer patients and 203 endometrial cancer patients |
To assess the accuracy of staging positron emission tomography (PET)/computed tomography (CT) in detecting distant metastasis in patients with local-regionally advanced cervical and high-risk endometrial cancer in the clinical trial by the American College of Radiology Imaging Network (ACRIN) and the Gynecology Oncology Group (GOG) (ACRIN 6671/GOG 0233) and to compare central and institutional reader performance. |
Overall prevalence of distant metastasis was 13.7% (21 of 153) for cervical cancer and 11.8% (24 of 203) for endometrial cancer. Central reader PET/CT interpretation demonstrated sensitivity, specificity, positive predictive value (PPV), and negative predictive value of 54.8%, 97.7%, 79.3%, and 93.1% for cervical cancer metastasis versus 64.6%, 98.6%, 86.1%, and 95.4% for endometrial cancer, respectively. By comparison, local institutional review demonstrated sensitivity, specificity, PPV, and negative predictive value of 47.6%, 93.9%, 55.6%, and 91.9% for cervical cancer metastasis and 66.7%, 93.9%, 59.3%, and 95.5% for endometrial cancer, respectively. For central readers, the specificity and PPV of PET/CT detection of cervical and endometrial cancer metastases were all significantly higher compared with that of local institutional review (P < .05). Central reader area under the receiver operating characteristic curve (AUC) values were 0.78 and 0.89 for cervical and endometrial cancer, respectively; these were not significantly different from local institutional AUC values (0.75 and 0.84, respectively; P > .05 for both). |
2 |
14. Shin MS, Shingleton HM, Partridge EE, Nicolson VM, Ho KJ. Squamous cell carcinoma of the uterine cervix. Patterns of thoracic metastases. Invest Radiol. 30(12):724-9, 1995 Dec. |
Review/Other-Dx |
62 cases |
To evaluate the radiographic patterns of its thoracic metastases correlating with the pathways of metastatic tumor spread. |
In addition to the most typical pattern of multiple pulmonary nodules (71%), mediastinal and hilar lymphadenopathy (32%) and pleural metastases (27%) were frequently observed. Rare findings included bone metastases (6%), endobronchial obstruction (5%), and lymphangitic carcinomatosis (3%). |
4 |
15. Kim TH, Kim MH, Kim BJ, Park SI, Ryu SY, Cho CK. Prognostic Importance of the Site of Recurrence in Patients With Metastatic Recurrent Cervical Cancer. Int J Radiat Oncol Biol Phys. 98(5):1124-1131, 2017 08 01. |
Observational-Dx |
1322 patients |
To investigate the survival outcomes according to the recurrence site in a large cohort of cervical cancer patients. |
Regarding the pattern of recurrence, distant-only (DO) recurrence was most common (59.5%), followed by combined (21.5%), central (cervix or vaginal stump; 10.7%), and pelvic (pelvic lymph nodes or pelvic side wall; 8.3%) recurrence. Two subgroups (distant lymph nodes and lung parenchyma) of the DO group demonstrated remarkably good prognosis and were categorized as type A DO; the other subgroups were labeled type B DO. Patients with type A DO recurrence constituted 36% of all recurrences and 83.8% of them received AST. The 5-year overall survival rates were significantly greater in the type A DO group than in the other groups (44.8% in the type A DO group, 12.6% in the pelvic group, and 6.8% in the type B DO group). |
4 |
16. Shu T, Bai P, Zhang R, Li S. [Clinical analysis and prognostic factors in 106 patients with stage Ia-IIb cervical cancer with pulmonary metastasis]. [Chinese]. Chung Hua Chung Liu Tsa Chih. 36(9):703-7, 2014 Sep. |
Observational-Dx |
106 patients |
To investigate the clinical characteristics and prognostic factors for patients with stage Ia-IIb cervical cancer with pulmonary metastasis (CCMP). |
Pulmonary metastases were detected in 89 (83.9%) out of a total of 106 patients within 2 years after initial treatment of cervical cancer. The median disease-free interval (DFI) of the 106 patients was 13 months. The median survival after CCMP was 18 months, with 2-year and 5-year survival rates of 37.7% and 7.5%, respectively. Metastases were mainly distributed in the inferior lobe of right lung. The surgical treatment was proven to be clinically effective in both unilateral and bilateral CCMP. The response rate was 60.2% in patients choosing non-operative treatment. The univariate analysis showed that pathological type of cervix carcinoma, low degree of differentiation, scope of pulmonary metastasis and whether CCMP simultaneously accompanied with other parts of recurrence were closely related to the prognosis, while the differentiation of cervical tumor was an independent prognostic factor drawn from multivariate regression analysis. |
4 |
17. Ki EY, Lee KH, Park JS, Hur SY. A Clinicopathological Review of Pulmonary Metastasis from Uterine Cervical Cancer. Cancer Res. Treat.. 48(1):266-72, 2016 Jan. |
Observational-Dx |
56 patients |
To investigate the clinicopathological features of pulmonary metastasis from cervical cancer. |
Fifty-six patients were diagnosed with pulmonary metastasis from cervical cancer. The prevalence of pulmonary metastasis was 3.6%. The mean event-free duration was 12 months. Twelve patients underwent surgical removal of metastatic lesions. The overall survival (OS) of patients with </= 3 metastatic lung lesions was 40.7 months, longer than those with > 4 lesions (25 months, p=0.034). The OS of patients who underwent surgical resection was 53.8 months, longer than that of those who did not (p=0.006). In addition, the OS of patients with adjuvant platinum-based chemotherapy was 32.6 months (p=0.027). |
4 |
18. Lamoreaux WT, Grigsby PW, Dehdashti F, et al. FDG-PET evaluation of vaginal carcinoma. Int J Radiat Oncol Biol Phys. 2005; 62(3):733-737. |
Observational-Dx |
23 patients |
To compare the results of CT and FDG-PET in the detection of the primary tumor and lymph node metastases in carcinoma of the vagina. |
Of the 21 patients with an intact primary tumor, CT visualized it in 9 (43%). CT also demonstrated abnormally enlarged groin lymph nodes in 3 patients and both groin and pelvic lymph nodes in 1 patient (4/23, 17%). FDG-PET identified abnormal uptake in all 21 intact primary tumors (100%). Abnormal uptake was found in the groin lymph nodes in 4 patients, pelvic lymph nodes in 2, and both groin and pelvic lymph nodes in 2 patients (8/23, 35%). The 3-year PFS and OS estimate was 73% and 68%, respectively. |
3 |
19. Hricak H, Gatsonis C, Chi DS, et al. Role of imaging in pretreatment evaluation of early invasive cervical cancer: results of the intergroup study American College of Radiology Imaging Network 6651-Gynecologic Oncology Group 183. J Clin Oncol. 2005; 23(36):9329-9337. |
Observational-Dx |
208 patients |
To compare MRI and CT with each other and to FIGO clinical staging in the pretreatment evaluation of early invasive cervical cancer, using surgicopathologic findings as the reference standard. |
Complete data were available for 172 patients; surgicopathologic findings were consistent with FIGO stages IA to IIA in 76% and stage =IIB in 21%. For the detection of advanced stage (=IIB), sensitivity was poor for FIGO clinical staging (29%), CT (42%), and MRI (53%); specificity was 99% for FIGO clinical staging, 82% for CT, and 74% for MRI; and NPV was 84% for FIGO clinical staging, 84% for CT, and 85% for MRI. MRI (AUC, 0.88) was significantly better than CT (AUC, 0.73) for detecting cervical tumors (P=.014). For 85% of patients, FIGO clinical staging forms were submitted after MRI and/or CT was performed. |
3 |
20. Woo S, Suh CH, Kim SY, Cho JY, Kim SH. 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. [Review]. Eur Radiol. 28(2):530-541, 2018 Feb. |
Meta-analysis |
14 studies |
To review the diagnostic performance of MRI for detection of parametrial invasion (PMI) in cervical cancer patients. |
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), Tau(2) (0.240), Higgins I(2) (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. |
Good |
21. Tsili AC, Tsangou V, Koliopoulos G, Stefos T, Argyropoulou MI. Early-stage cervical carcinoma: the role of multidetector CT in correlation with histopathological findings. J Obstet Gynaecol 2013;33:882-7. |
Observational-Dx |
22 patients |
To assess the diagnostic performance of multidetector CT (MDCT) in staging patients with surgical-pathological proven early-stage cervical carcinoma. |
The overall accuracy of MDCT in detecting and staging primary cervical carcinoma was 86% and 86%, respectively. Our results showed good diagnostic performance of MDCT in the detection and local staging of early-stage cervical carcinoma. |
4 |
22. Grigsby PW, Siegel BA, Dehdashti F. Lymph node staging by positron emission tomography in patients with carcinoma of the cervix. J Clin Oncol. 2001;19(17):3745-3749. |
Observational-Dx |
101 consecutive patients |
To retrospectively compare the results of CT and FDG-PET for lymph node staging in patients with carcinoma of the cervix and to evaluate the relationship of the imaging findings to prognosis. |
CT demonstrated abnormally enlarged pelvic lymph nodes in 20 (20%) and para-aortic lymph nodes in 7 (7%) of the 101 patients. PET demonstrated abnormal FDG uptake in pelvic lymph nodes in 67 (67%), in para-aortic lymph nodes in 21 (21%), and in supraclavicular lymph node in 8(8%). The 2-year progression-free survival, based solely on para-aortic lymph node status, was 64% in CT-negative and PET-negative patients, 18% in CT-negative and PET-positive patients, and 14% in CT-positive and PET-positive patients (P<.0001). A multivariate analysis demonstrated that the most significant prognostic factor for progression-free survival was the presence of positive para-aortic lymph nodes as detected by PET imaging (P=.025). Study demonstrates that FDG-PET detects abnormal lymph node regions more often than does CT and that the findings on PET are a better predictor of survival than those of CT in patients with carcinoma of the cervix. |
3 |
23. Atri M, Zhang Z, Dehdashti F, et al. Utility of PET-CT to evaluate retroperitoneal lymph node metastasis in advanced cervical cancer: Results of ACRIN6671/GOG0233 trial. Gynecol Oncol. 142(3):413-9, 2016 Sep. |
Observational-Dx |
153 patients |
To assess if FDG PET combined with diagnostic CT improves diagnostic CT accuracy to detect lymph node (LN) metastasis in advanced cervical cancer. |
Forty-three of 153 patients had metastasis to abdominal LNs. Sample size calculation required review of the first 40 abdominal positive and 40 randomly selected abdominal negative studies. Patients were 24 to 74years (48.9+/-10.6) old. Mean sensitivities of PET-DCT/DCT for detection of LN metastasis in abdomen were 0.50 (CI: 0.44, 0.56) and 0.42 (CI: 0.36, 0.48) (p=0.052) and in pelvis 0.83 (CI: 0.78, 0.87) and 0.79 (CI: 0.73, 0.83) (p=0.15). Corresponding specificities were 0.85 (CI: 0.80, 0.89) and 0.89 (CI: 0.84, 0.92) (p=0.21) and 0.63 (CI: 0.54, 0.70) and 0.62 (CI: 0.53, 0.69) (p=0.83). Mean AUC values were 0.70 (CI: 0.61, 0.79) and 0.68 (CI: 0.59, 0.77) (p=0.43) and 0.80 (CI: 0.71, 0.88) and 0.76 (CI: 0.67, 0.85) (p=0.21) respectively. |
3 |
24. Liu B, Gao S, Li S. A Comprehensive Comparison of CT, MRI, Positron Emission Tomography or Positron Emission Tomography/CT, and Diffusion Weighted Imaging-MRI for Detecting the Lymph Nodes Metastases in Patients with Cervical Cancer: A Meta-Analysis Based on 67 Studies. [Review]. Gynecol Obstet Invest. 82(3):209-222, 2017. |
Observational-Dx |
233 CT/PET patients;245 MR/PET patients |
To evaluate the diagnostic performances of computed tomography (CT), magnetic resonance (MR) imaging, and (18)F-fluorodeoxyglucose-positron emission tomography ((18)F-FDG-PET) in detecting hematogenous bone metastasis in patients with cervical cancer. |
PET was more sensitive than CT (P = .004) and was more specific than MR imaging (P = .04). The diagnostic performance of PET was significantly superior to the performance CT (AUC, 0.964 vs 0.662; P < .001) and MR (AUC, 0.966 vs 0.833; P = .033). Both FIGO stage and the extent of lymph node metastases were associated with hematogenous bone metastasis in univariate analysis. However, the extent of lymph node metastases was the only significant risk factor in multivariate analysis (P = .025). |
3 |
25. Liu FY, Yen TC, Chen MY, et al. Detection of hematogenous bone metastasis in cervical cancer: 18F-fluorodeoxyglucose-positron emission tomography versus computed tomography and magnetic resonance imaging. Cancer. 115(23):5470-80, 2009 Dec 01. |
Observational-Dx |
Group CT/PET – 233 imaging pairs in 190 patients; Group MR/PET – 245 imaging pairs in 228 patients |
Retrospective study in which the authors evaluated the diagnostic performances of CT, MRI, and FDG-PET in detecting hematogenous bone metastasis in patients with cervical cancer. For CT and MRI studies, the imaging findings were interpreted by 2 radiologists. For PET studies, the imaging findings were interpreted by 2 nuclear physicians. |
PET was more sensitive than CT (P=.004) and more specific than MRI (P=.04). The diagnostic performance of PET was significantly superior to the performance CT (AUC, 0.964 vs 0.662; P<.001) and MRI (AUC, 0.966 vs 0.833; P=.033). Both FIGO stage and the extent of lymph node metastases were associated with hematogenous bone metastasis in univariate analysis. However, the extent of lymph node metastases was the only significant risk factor in multivariate analysis (P=.025). The current study demonstrated the superiority of FDG-PET over CT and MRI for detecting hematogenous bone metastasis in patients with advanced cervical cancer. Hematogenous bone metastasis in cervical cancer was associated with the extent of lymph node metastases rather than with FIGO stage. |
3 |
26. Robertson NL, Hricak H, Sonoda Y, et al. The impact of FDG-PET/CT in the management of patients with vulvar and vaginal cancer. Gynecologic Oncology. 140(3):420-4, 2016 Mar. |
Observational-Dx |
50 patients |
To evaluate the changes in prognostic impression and patient management following positron emission tomography/computedtomography (PET/CT) in patients with vulvar and vaginal carcinoma; and to compare PET/CT findings with those of conventional imaging modalities. |
54/83 (65%) studies included had a diagnosis of vulvar cancer, and the remaining 29/83 (35%), a diagnosis of vaginal cancer. Following FDG-PET/CT, the physician's prognostic impression changed in 51% of cases. A change in patient management, defined as a change to/from a non-interventional strategy (observation or additional imaging), to/from an interventional strategy (biopsy or treatment), was documented in 36% of studies. The electronic records demonstrated that 95% of the management strategies recorded in the physician questionnaires were implemented as planned. MRI and/or CT were performed within one month of the Fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) in 20/83 (24%) and 28/83 (34%) cases, respectively. FDG-PET/CT detected nodes suspicious for metastases on 29/83 (35%) studies performed. MRI and CT detected positive nodes on 6 and 11 studies respectively. Distant metastases were identified in 10 cases imaged with FDG-PET and 5 cases that had additional conventional CT imaging. All suspicious lesions seen on CT were positively identified on PET/CT. In 4 cases, an abnormality identified on PET/CT, was not seen on diagnostic CT. |
3 |
27. NCCN Clinical Practice Guidelines in Oncology. Cervical Cancer. Version 1.2020. Available at: https://www.nccn.org/professionals/physician_gls/pdf/cervical.pdf. |
Review/Other-Dx |
N/A |
To present NCCN clinical guideines for cervical cancer. |
No results stated in abstrast. |
4 |
28. Taylor MB, Dugar N, Davidson SE, Carrington BM. Magnetic resonance imaging of primary vaginal carcinoma. Clin Radiol. 62(6):549-55, 2007 Jun. |
Review/Other-Dx |
25 patients |
To describe the MRI features of vaginal carcinoma and to suggest a role for MRI in its management. |
The median patient age was 54 years (range 31-86 years). Tumor maximum diameter ranged from 1.6-11.3 cm (mean 3.7 cm). Most tumors were of iso-intense signal to muscle on T1-weighted images and hyper-intense to muscle on T2-weighted images. 88% of patients had tumor extending beyond the vagina and 56% of patients had FIGO stage III or above tumors. 16 patients were treated with RT (2 with chemoradiotherapy), 5 with surgery and 4 with supportive care. 10 patients (40%) died of their disease during the study period. The MRI stage of the tumor correlated with survival. |
4 |
29. Husain A, Akhurst T, Larson S, Alektiar K, Barakat RR, Chi DS. A prospective study of the accuracy of 18Fluorodeoxyglucose positron emission tomography (18FDG PET) in identifying sites of metastasis prior to pelvic exenteration. Gynecol Oncol. 106(1):177-80, 2007 Jul. |
Observational-Dx |
20 patients |
To determine the accuracy of (18)FDG PET in identifying sites of metastatic disease prior to pelvic exenteration or radical resection in patients (pts) with recurrent cervical or vaginal cancers. |
All pts had undergone prior pelvic radiation therapy and five patients had also received chemotherapy. CT/MRI scans identified three patients with possible metastatic disease in the following sites: (1) iliac nodes (2 pts) and (2) lungs (1 pt). After surgical and pathological evaluation, only one of these sites, the lungs, was confirmed to have metastatic disease. PET scans identified possible metastatic disease in nine patients and included the following sites: (1) pelvic nodes (4 pts), (2) para-aortic nodes (2 pts), (3) axillary node (1 pt), (4) bowel wall (1 pt) and (5) lungs (1 pt). After surgical and pathologic evaluation metastatic disease was identified in five of these pts at the following sites: iliac nodes, 2; para-aortic nodes, 1; bowel wall, 1; and lungs, 1. Of the sites identified by PET scan as areas of metastasis CT scan only identified the pulmonary metastasis. 18)FDG PET was found to have a sensitivity of 100% and a specificity of 73% in detecting sites of extra-pelvic metastasis and may be the most accurate test to determine eligibility for pelvic exenteration. |
3 |
30. Brar H, May T, Tau N, et al. Detection of extra-regional tumour recurrence with 18F-FDG-PET/CT in patients with recurrent gynaecological malignancies being considered for radical salvage surgery. Clinical Radiology. 72(4):302-306, 2017 Apr. |
Observational-Dx |
85 patients |
To compare the detection rate of extra-regional metastases in patients with recurrent gynaecological malignancies being considered for radical salvage surgery with combined 2-[(18)F]-fluoro-2-deoxy-d-glucose ((18)F-FDG) positron-emission tomography (PET)/computed tomography (CT) compared to conventional imaging. |
There were 85 patients (median age, 50 years; range: 30-81 years) with carcinoma of cervix (n=51), endometrium (n=18), vagina (n=6), or vulva (n=10). Extra-regional recurrence was detected in 8/85 (9.4%) and 24/85 (28.2%) patients on conventional imaging and PET, respectively (p=0.0017). The greatest impact of PET compared to conventional imaging was in the detection of extra-regional nodal metastases. PET had significantly fewer examinations equivocal for extra-regional recurrence versus conventional imaging (6/85 [7.1%] and 38/85 [44.7%], respectively, p<0.001). |
3 |
31. Gardner CS, Sunil J, Klopp AH, et al. Primary vaginal cancer: role of MRI in diagnosis, staging and treatment. [Review]. British Journal of Radiology. 88(1052):20150033, 2015 Aug. |
Review/Other-Dx |
N/A |
To illustrate the utility of MRI in patients with primary vaginal cancer and highlight key aspects of staging, treatment, recurrence and complications. |
No results stated in abstract. |
4 |
32. Donati OF, Lakhman Y, Sala E, et al. Role of preoperative MR imaging in the evaluation of patients with persistent or recurrent gynaecological malignancies before pelvic exenteration. European Radiology. 23(10):2906-15, 2013 Oct. |
Observational-Dx |
50 patients |
To determine the diagnostic performance of MRI in assessing local tumour extent and evaluate associations between MRI features and survival in patients undergoing MRI before pelvic exenteration for persistent or recurrent gynaecological cancers. |
Areas under receiver operating characteristic curves (AUCs) for invasion of the bladder, rectum and pelvic sidewall were 0.96, 0.90 and 0.98 for reader 1 and 0.95, 0.88 and 0.90 for reader 2. Corresponding sensitivities/specificities were 87.0 %/92.6 %, 81.3 %/97.0 % and 87.5 %/97.2 % for reader 1, and 87.0 %/100.0 %, 75.0 %/97.0 % and 75.0 %/94.4 % for reader 2. Inter-reader agreement was excellent for organ invasion (kappa = 0.81-0.85). Pelvic sidewall invasion on MRI was associated with overall and recurrence-free survival (P = 0.01-0.04 for the two readers). |
3 |
33. Mongula J, Slangen B, Lambregts D, et al. Predictive criteria for MRI-based evaluation of response both during and after radiotherapy for cervical cancer. J. Contemp. Brachytherapy. 8(3):181-8, 2016 Jun. |
Observational-Dx |
42 patients |
To assess magnetic resonance imaging (MRI) to evaluate presence of local residual disease during and after RT for Federation of Gynecology and Obstetrics (FIGO) stage Ib1-IVa cervical cancer. |
Seven patients had residual disease. Area under the receiver operating characteristics curve (AUC) for 'subjective' visual assessment was 0.79/0.75 (observer 1/observer 2) after RT and 0.75/0.43 at final BCT. The combined 'objective' MRI criteria (isointense, nodular, and irregular) resulted in improved prediction of residual tumor (AUCs of 0.91/0.85 after RT). For the less experienced observer, the MRI criteria set significantly improved prediction of residual tumor compared to 'subjective' visual assessment. Observer dependency decreased, kappa of 0.41 compared to 0.84 for the MRI criteria set after RT. |
3 |
34. Vincens E, Balleyguier C, Rey A, et al. Accuracy of magnetic resonance imaging in predicting residual disease in patients treated for stage IB2/II cervical carcinoma with chemoradiation therapy : correlation of radiologic findings with surgicopathologic results. Cancer. 113(8):2158-65, 2008 Oct 15. |
Observational-Dx |
44 patients |
To correlate MRI and histologic findings specifically in cervix cancer. |
Twelve patients (27%) had achieved a radiologic complete response, 16 patients (36.5%) had unclassified lesions (RD or 'fibrosis'), and 16 patients (36.5%) had radiologic residual tumor. According to the histologic results, 19 patients (43%) had no RD, 10 patients (23%) had inframillimeter RD, 2 patients (5%) had RD that measured <1 cm, and 13 patients (29%) had RD that measured >1 cm. The sensitivity and specificity of MRI in evaluating RD were 80% and 55%, respectively. |
3 |
35. Byun JM, Kim YN, Jeong DH, Kim KT, Sung MS, Lee KB. Three-dimensional transvaginal ultrasonography for locally advanced cervical cancer. International Journal of Gynecological Cancer. 23(8):1459-64, 2013 Oct. |
Observational-Dx |
24 patients |
To evaluate the feasibility of using 3-dimensional transvaginal ultrasound (3D-TVUS) to diagnose the extent of invasive cervical cancer. |
With respect to cancer staging, accuracy was 62.5% with clinical examination, 40.9% with MRI, and 66.7% with TVUS. Magnetic resonance imaging demonstrated both low specificity (64.3%) and accuracy (68.2%) for nodal involvement. For the detection of parametrial invasion: sensitivity was 25% with clinical exanimation, 75% with MRI, and 75% with TVUS; specificity was 55.6% with MRI and 90% with TVUS; accuracy was 59% with MRI and 87.5% with TVUS. Although there was no case with bladder or rectal invasion, TVUS and MRI showed high specificity for the assessment of these. Clinical examination was useful for the detection of vaginal involvement. |
3 |
36. Moloney F, Ryan D, Twomey M, Hewitt M, Barry J. Comparison of MRI and high-resolution transvaginal sonography for the local staging of cervical cancer. J Clin Ultrasound. 44(2):78-84, 2016 Feb. |
Observational-Dx |
46 patients |
To compare the diagnostic accuracy of transvaginal sonography (TVS) with that of MRI in the local staging of cervical cancer. |
We found a strong correlation between MRI and TVS in the assessment of tumor volume in both early-stage and advanced-stage disease (p < 0.0001). Both MRI and TVS had a sensitivity of 80%, a specificity of 50%, and a diagnostic accuracy of 63.6% for the detection of stromal invasion in early-stage disease. For the detection of parametrial invasion, we found sensitivity rates of 40% for MRI and 86% for TVS; specificity rates of 78.8% for MRI and 20% for TVS; and diagnostic accuracy rates of 89% for MRI and 78.7% for TVS. A matched-sample analysis revealed that there was no statistically significant difference between MRI and TVS in the assessment of stromal or parametrial invasion (p = 0.06). |
3 |
37. Arribas S, Alcazar JL, Arraiza M, Benito A, Minguez JA, Jurado M. Three-Dimensional Transvaginal Sonography and Magnetic Resonance Imaging for Local Staging of Cervical Cancer: An Agreement Study. Journal of Ultrasound in Medicine. 35(5):867-73, 2016 May. |
Observational-Dx |
40 patients |
To evaluate the agreement of clinical examination, 2-dimensional (2D) sonography, and 3-dimensional (3D) sonography with magnetic resonance imaging (MRI) for local staging of cervical cancer. |
Eleven had early-stage (IA and IB1) disease, and 29 had advanced-stage (IB2-IVB) disease. A significant correlation for tumor size estimation was found between MRI and pelvic examination (r = 0.754; P < .001), MRI and 2D sonography (r = 0.649; P < .001), and MRI and 3D sonography (r = 0.657; P< .001). Agreement for parametrial infiltration between MRI and pelvic examination was fair (kappa = 0.26; 95% confidence interval [CI], 0.10-0.54; 62.5% agreement), between MRI and 2D sonography was moderate (kappa = 0.41; 95% CI, 0.15-0.66; 70.0% agreement), and between MRI and 3D sonography was good (kappa = 0.60; 95% CI, 0.35-0.85; 80.0% agreement). Agreement for bladder involvement between MRI and pelvic examination was moderate (kappa = 0.48; 95% CI, 0.10-0.99; 95.0% agreement), between MRI and 2D sonography was moderate (kappa = 0.48; 95% CI, 0.10-0.99; 95.0% agreement), and between MRI and 3D sonography was very good (kappa = 0.84; 95% CI, 0.55-1.0; 97.5% agreement). Agreement for rectal involvement was not calculated because of the very small number of cases. |
3 |
38. Chiappa V, Di Legge A, Valentini AL, et al. Agreement of two-dimensional and three-dimensional transvaginal ultrasound with magnetic resonance imaging in assessment of parametrial infiltration in cervical cancer. Ultrasound Obstet Gynecol. 45(4):459-69, 2015 Apr. |
Observational-Dx |
29 patients |
To compare two-dimensional (2D) and three-dimensional (3D) transvaginal ultrasound with magnetic resonance imaging (MRI) as the gold standard in assessment of parametrial infiltration of cervical cancer and to determine if all parts of the cervix are equally assessable with ultrasound. |
The percentage agreement between 2D ultrasound and MRI in assessing parametrial infiltration (yes or no) was 76% (kappa, 0.459) and that between 3D ultrasound and MRI was 79% (kappa, 0.508). The results of 2D ultrasound showed the following agreement with those of MRI: 90% for the ventral parametrium (kappa, 0.720), 72% for the right lateral parametrium (kappa, 0.494), 69% for the left lateral parametrium (kappa, 0.412) and 58.5% for the dorsal parametrium (kappa, 0.017). The results of 3D ultrasound showed the following agreement with those of MRI: 62.5% for the ventral parametrium (kappa, 0.176), 81% for the right lateral parametrium (kappa, 0.595), 70% for the left lateral parametrium (kappa, 0.326) and 52% for the dorsal parametrium (kappa, 0.132). The best agreement between 3D ultrasound and MRI was for the middle cervical cylinder (76%; kappa, 0.438) and the poorest agreement was for the caudal cylinder (42%; kappa, 0.125). |
2 |
39. Testa AC, Ludovisi M, Manfredi R, et al. Transvaginal ultrasonography and magnetic resonance imaging for assessment of presence, size and extent of invasive cervical cancer. Ultrasound Obstet Gynecol. 34(3):335-44, 2009 Sep. |
Observational-Dx |
33 patients |
To prospectively assess the diagnostic performance of transvaginal ultrasound and magnetic resonance imaging (MRI), using histology as the gold standard, with regard to the presence, size, and extent of invasive cervical cancers and the detection of metastatic lymph nodes. |
An invasive cervical cancer tumor was confirmed in the 33 patients triaged for primary surgery. A residual tumor mass was documented in 27 out of 35 patients (77%) who underwent surgery after neoadjuvant treatment, with no residual tumor in eight (23%) cases. Transvaginal ultrasound and MRI examinations showed the presence of the tumor mass in 56/60 (93%) and in 53/60 (88%) cases, respectively. Ultrasound and MRI detected the depth of stromal invasion to be greater than two-thirds with a sensitivity of 100% (16/16) and 94% (15/16) (P = 1) and a false-positive rate of 25% (13/52) and 15% (8/52) (P = 0.58), respectively. Both ultrasound and MRI provided low sensitivities (3/5, 60% and 2/5, 40% respectively, P = 1) and the same false-positive rate (7/63, 11%) for the presence of parametrial infiltration. One of the 11 patients with metastatic lymph nodes was detected at ultrasound examination (sensitivity 9%) with no false-positive cases, while MRI correctly identified three positive cases (sensitivity 27%, 3/11) with two false-positive cases (false positive rate 4%, 2/55). |
2 |
40. Schwarz JK, Siegel BA, Dehdashti F, Grigsby PW. Association of posttherapy positron emission tomography with tumor response and survival in cervical carcinoma. JAMA. 2007; 298(19):2289-2295. |
Observational-Dx |
92 women |
To validate the association between the metabolic response on the 3-month post-therapy FDG-PET and long-term survival outcome. |
Post-therapy FDG-PET showed a complete metabolic response in 65 patients (70%), a partial metabolic response in 15 (16%), and progressive disease in 12 (13%). Their 3-year PFS rates were 78%, 33%, and 0%, respectively (P<.001). Multivariate analysis demonstrated that the HR for risk of recurrence based on the post-therapy metabolic response showing progressive disease was 32.57 (95% CI, 10.22-103.82). A partial metabolic response had an HR of 6.30 (95% CI, 2.73-14.56). These were more predictive of survival outcome than the pretreatment lymph node status (HR, 3.54; 95% CI, 1.54-8.09). |
4 |
41. Liu FY, Su TP, Wang CC, et al. Roles of posttherapy 18F-FDG PET/CT in patients with advanced squamous cell carcinoma of the uterine cervix receiving concurrent chemoradiotherapy. Eur J Nucl Med Mol Imaging. 45(7):1197-1204, 2018 07. |
Observational-Dx |
55 patients |
To assess the clinical roles of [(18)F]fluorodeoxyglucose ((18)F-FDG) positron emission tomography/computed tomography (PET/CT) performed 2-3 months after completion of concurrent chemoradiotherapy (CCRT), along with pretherapy characteristics, in patients with advanced squamous cell carcinoma of the uterine cervix enrolled in a prospective randomized clinical trial. |
PET/CT scans (n = 55) were positive, equivocal and negative in 9, 13 and 33 patients, respectively. All patients with positive scans were confirmed to have residual or metastatic disease and died despite salvage therapies. There is a significant OS difference between patients with positive and equivocal scans (P < .001) but not between patients with equivocal and negative scans (P = .411). Positive pretherapy PALN is associated with positive posttherapy PET/CT (P = .033) and predicts a poorer survival in patients with equivocal or negative posttherapy PET/CT (P < .001). |
3 |
42. Siva S, Herschtal A, Thomas JM, et al. Impact of post-therapy positron emission tomography on prognostic stratification and surveillance after chemoradiotherapy for cervical cancer. Cancer. 117(17):3981-8, 2011 Sep 01. |
Observational-Dx |
105 patients |
To investigate the detection of relapse and survival outcomes in patients with cervical cancer treated with curative intent chemoradiotherapy, and evaluated with a post-therapy (18) F-fluorodeoxyglucose positron emission tomography (FDG-PET) scan. |
Median follow-up was 36 months. At post-therapy FDG-PET, 73 (70%) patients had complete metabolic response, 10 (9%) had partial metabolic response, and 22 (21%) had progressive metabolic disease. Overall survival at 3 years was 77% in all patients, and 95% for those with complete metabolic response. On multivariate analysis, complete metabolic response (P < .0001) and pretreatment tumor volume (P = .041) were strong predictors for overall survival. The number of involved lymph nodes (P < .005) and International Federation of Gynecology and Obstetrics stage (P = .04) were predictive of relapse-free survival. In total, 18 patients relapsed at a single site, and 13 underwent salvage, with a 3-year survival of 67%. Patients with complete metabolic response had a distant failure rate 36-fold less than those with partial metabolic response (P < .0001). After complete metabolic response, only 1 patient (1.6%) relapsed without symptoms and was detected through physical examination. |
3 |
43. Salani R, Khanna N, Frimer M, Bristow RE, Chen LM. An update on post-treatment surveillance and diagnosis of recurrence in women with gynecologic malignancies: Society of Gynecologic Oncology (SGO) recommendations. Gynecologic Oncology. 146(1):3-10, 2017 07. |
Review/Other-Dx |
N/A |
To provide an update on surveillance for gynecologic cancer recurrence in women who have had a complete response to primary cancer therapy. |
No results stated in abstract. |
4 |
44. Bipat S, Glas AS, van der Velden J, Zwinderman AH, Bossuyt PM, Stoker J. Computed tomography and magnetic resonance imaging in staging of uterine cervical carcinoma: a systematic review. Gynecol Oncol. 2003; 91(1):59-66. |
Review/Other-Dx |
57 articles |
To systematically review the available evidence on the diagnostic performance of CT and MRI in staging of cervical carcinoma. |
57 articles were included. In 49 articles one imaging modality was evaluated (MRI, 38; CT, 11), and in 8 articles, both. Inclusion criteria were: minimum of 10 patients included, histopathology as reference standard, sufficient data presented to construct 2(x) 2 tables. The exclusion criterion was: data reported elsewhere in more detail. Sensitivity estimates for parametrial invasion were 74% (95% CI, 68%-79%) for MRI and 55% (95% CI, 44%-66%) for CT, and for lymph node involvement, 60% (95% CI, 52%-68%) and 43% (95% CI, 37%-57%), respectively. MRI and CT had comparable specificities for parametrial invasion and lymph node involvement. For bladder invasion and rectum invasion the sensitivities for MRI were respectively 75% (95% CI, 66%-83%) and 71% (95% CI, 53%-83%), higher compared with CT. The specificity in evaluating bladder invasion for MRI was significantly higher compared with CT: 91% (95% CI, 83%-95%) for MRI and 73% (95% CI, 52%-87%) for CT. The specificities for rectum invasion were comparable. Differences in patient sample size, publication year, methodological criteria, and MRI techniques had no effect on the summary estimates. |
4 |
45. Alcazar JL, Arribas S, Minguez JA, Jurado M. The role of ultrasound in the assessment of uterine cervical cancer. [Review]. J Obstet Gynaecol India. 64(5):311-6, 2014 Oct. |
Review/Other-Dx |
N/A |
To review the role of ultrasound in the asssessment of uterine cervical cancer. |
No results stated in abstract. |
4 |
46. Frank SJ, Jhingran A, Levenback C, Eifel PJ. Definitive radiation therapy for squamous cell carcinoma of the vagina. Int J Radiat Oncol Biol Phys. 2005; 62(1):138-147. |
Observational-Tx |
193 patients |
To evaluate outcome and describe clinical treatment guidelines for patients with primary squamous cell carcinoma of the vagina treated with definitive RT. |
Disease-specific survival and pelvic disease control rates correlated with FIGO stage and tumor size. At 5 years, disease-specific survival rates were 85% for the 50 patients with stage I, 78% for the 97 patients with stage II, and 58% for the 46 patients with stage III-IVA disease (P=0.0013). 5-year disease-specific survival rates were 82% and 60% for patients with tumors =4 cm or >4 cm, respectively (P=0.0001). At 5 years, pelvic disease control rates were 86% for stage I, 84% for stage II, and 71% for stage III-IVA (P=0.027). The predominant mode of relapse after definitive RT was local-regional (68% and 83%, respectively, for patients with stages I-II or III-IVA disease). The incidence of major complications was correlated with FIGO stage; at 5 years, the rates of major complications were 4% for stage I, 9% for stage II, and 21% for stage III-IVA (P<0.01). |
2 |
47. Burger IA, Vargas HA, Donati OF, et al. The value of 18F-FDG PET/CT in recurrent gynecologic malignancies prior to pelvic exenteration. Gynecologic Oncology. 129(3):586-592, 2013 Jun. |
Observational-Dx |
33 patients |
To assess the performance of [(18)F]-FDG PET/CT for delineating disease extent and evaluated the association between quantitative FDG uptake metrics (SUVmax, total lesion glycolysis [TLG] and metabolic tumor volume [MTV]) and progression-free survival (PFS) and overall survival (OS). |
33 patients (mean age 56years, range: 28-81) were included; primary sites of disease were the cervix (n=18), uterus (n=8) and vagina/vulva (n=7). AUCs for organ invasion ranged from 0.74 to 0.96. There was a significant association between FDG uptake metrics incorporating tumor volume (TLG and MTV) and OS (p</=0.001) as well as between MTV and PFS (p=0.001). No significant association was identified between SUVmax and OS/PFS (p=0.604/0.652). Inter-reader agreement for organ invasion was fair to substantial (k=0.36-0.74) and almost perfect for FDG quantification (ICC=0.97-0.99). |
2 |
48. American College of Radiology. ACR Appropriateness Criteria® Radiation Dose Assessment Introduction. Available at: https://www.acr.org/-/media/ACR/Files/Appropriateness-Criteria/RadiationDoseAssessmentIntro.pdf. |
Review/Other-Dx |
N/A |
To provide evidence-based guidelines on exposure of patients to ionizing radiation. |
No abstract available. |
4 |