Küratif cerrahi tedavi uygulanan endometrium ve serviks kanserlerinde rekürrensin belirlenmesinde difüzyon ağırlıklı görüntülemenin tanı değeri
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Date
2016
Authors
Hacıkurt, Kadir
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Endometrium ve serviks kanserlerinde postoperatif dönemde rekürrensin belirlenmesinde difüzyon ağırlıklı (DA) manyetik rezonans görüntülemenin (MRG) tanı değerinin belirlenmesi ve konvansiyonel MRG sekansları ve kontrastlı sekanslar ile karşılaştırılması. Çalışmaya cerrahi ile tedavi edilmiş 52 endometrium ve 27 serviks kanserli olgu dahil edildi. Toplam 115 postoperatif MR incelemesi iki radyolog tarafından değerlendirildi ve MRG bulguları altın standart yöntem bulguları ile karşılaştırıldı. DA görüntülemenin lokal rekürrensi saptamada duyarlılığı %100, özgüllüğü %92,9, pozitif öngörü değeri (PÖD) %11,1, negatif öngörü değeri (NÖD) %100, yanlış pozitif (YP) oranı %7,1, yanlış negatif (YN) oranı %0 ve doğruluk oranı %92,1 bulundu. Özgüllük, NÖD ve doğruluk oranları rutin ve kontrastlı görüntülerle anlamlı farklılık göstermedi. Sekansların duyarlılık ve PÖD değerleri sadece bir olguda rekürrens bulunması nedeniyle optimal istatistiksel olarak hesaplanamadı ve performansları karşılaştırılamadı. DA MRG endometrium ve serviks kanserli olgularda lokal rekürrensin değerlendirilmesinde konvansiyonel ve kontrastlı MRG sekanslarına ek olarak kullanılabilen, tanıya yardımcı bir yöntemdir.
The aim of this study was to investigate the diagnostic value of diffusion-weighted magnetic resonance imaging (DW MRI) in determining recurrent disease in patients with endometrial and cervical cancer and to compare it with conventional MR sequences and post-contrast images. Fifty-two patients with endometrial cancer and 27 with cervical cancer treated with surgery were included in the study. A total of 115 MR examinations were evaluated by two radiologists and these findings were compared with findings of the gold standard method. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of DWI to determine local recurrence was 100%, 92.9%, 11.1%, 100% and 92.1%, respectively. There was no significant statistical difference between specificity, NPV and accuracy values of DWI and conventional sequences/post-contrast images. Sensitivity and PPV could not be compared because there was only one case with proven recurrent disease and statistical evaluation was incoclusive. DW MRI can be used together with conventional and post-contrast MR sequences to evaluate local recurrence in patients with endometrial and cervical cancer and makes contribution to diagnosis.
The aim of this study was to investigate the diagnostic value of diffusion-weighted magnetic resonance imaging (DW MRI) in determining recurrent disease in patients with endometrial and cervical cancer and to compare it with conventional MR sequences and post-contrast images. Fifty-two patients with endometrial cancer and 27 with cervical cancer treated with surgery were included in the study. A total of 115 MR examinations were evaluated by two radiologists and these findings were compared with findings of the gold standard method. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of DWI to determine local recurrence was 100%, 92.9%, 11.1%, 100% and 92.1%, respectively. There was no significant statistical difference between specificity, NPV and accuracy values of DWI and conventional sequences/post-contrast images. Sensitivity and PPV could not be compared because there was only one case with proven recurrent disease and statistical evaluation was incoclusive. DW MRI can be used together with conventional and post-contrast MR sequences to evaluate local recurrence in patients with endometrial and cervical cancer and makes contribution to diagnosis.
Description
Keywords
Endometrium ve serviks kanseri, Difüzyon ağırlıklı MRG, Rekürrens, Endometrial and cervical cancer, Diffusion-weighted MRI, Recurrence
Citation
Hacıkurt, K. (2016). Küratif cerrahi tedavi uygulanan endometrium ve serviks kanserlerinde rekürrensin belirlenmesinde difüzyon ağırlıklı görüntülemenin tanı değeri. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.