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Imaging Probe May Be More Accurate Than the Best External Detector for Early Cervical Cancer Diagnosis

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Key Points

  • Performing a type of scan known as diffusion-weighted imaging with an endovaginal probe allowed doctors to detect cervical tumors with a 78.2% sensitivity.
  • This finding compares with a sensitivity of 66.7% when using the external detection technique.
  • Adding diffusion-weighted imaging to the scan while using a probe also improved the specificity from 79.1% to 89.5%.

 

An endovaginal magnetic resonance imaging technique is more accurate at detecting early-stage cervical cancer than the best available external detection technique, a new study reported.

Researchers at The Institute of Cancer Research and The Royal Marsden Hospital found that using an endovaginal probe improved detection of early cervical cancer and could help doctors to better decide which women would benefit from fertility-sparing surgery. Their findings were published by Downey et al in European Radiology.

Background

The success of cell smear screening programs for cervical cancer means more and more women are diagnosed with earlier, more treatable forms of the disease. However, early tumors are smaller and more difficult to spot on conventional magnetic resonance images, and it is important for doctors to know the exact size and location of tumors before deciding which treatment a woman should receive.

For the first time, researchers have directly compared an endovaginal probe with the best available external detection technique. The study showed that use of an endovaginal probe was more effective than previously thought and that it allowed doctors to spot smaller tumors and identify women who might benefit from fertility-sparing surgery.

Study Findings

During the study, 48 patients with stage I cervical cancer were given optimized versions of both the endovaginal scan and the external array scan before they underwent surgery. A radiologist assessed the images, along with each woman’s clinical notes, and provided diagnoses in each case.

After surgery, tests were performed on the removed tissue to determine whether either scan had correctly predicted the presence or absence of a tumor. Diffusion-weighted imaging with an endovaginal probe detected tumors with a 78.2% sensitivity. This finding compares with a sensitivity of 66.7% when using the external detection technique. Adding diffusion-weighted imaging to the scan while using a probe also improved the specificity from 79.1% to 89.5%.

Study leader Nandita deSouza, MD, PhD, FRCP, FRCR, Professor of Translational Imaging at the Institute of Cancer Research, said, “We already know that use of an endovaginal probe can identify women who would benefit from fertility-sparing surgery—and we’ve been able to change patients’ surgical plans by using it. But to establish use of the technique more widely, it was important to formally compare it with the external coil technique. Our study showed that use of the endovaginal probe produced images that were clearer and could more accurately detect early cervical cancer than the external coil.”

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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