We describe a mnemonic device, “DISTANCE,” to enable a systematic approach to the interpretation of MR images, thereby enabling all the clinically relevant features to be adequately assessed: DIS, for Distance from the Inferior part of the tumor to the transitional Skin; T, for T staging; A, for Anal complex; N, for Nodal staging; C, for Circumferential resection margin; and E, for Extramural vascular invasion. Rectal cancer is a common and serious disease in the Western hemisphere. Optimal treatment of rectal cancer involves a multidisciplinary approach, with collaboration required between radiologists, oncologists, surgeons, and pathologists to achieve local control and decrease the rate of recurrence. Several studies have been published that show the ability to accurately stage rectal cancer with magnetic resonance (MR) imaging. Moreover, advances in preoperative therapies require accurate preoperative staging with MR imaging to select those patients who may benefit from more intensive treatment, without subjecting those who will not benefit to unnecessary treatment. As we enter an era of individualized patient care, stratified according to the risk of both local and distant failure, imaging takes on the same importance as the tumor type and genetic susceptibility. MR imaging is now an essential tool to enable the oncology team to make appropriate treatment decisions. However, rectal cancer evaluation with MR...
The Ovarian-Adnexal Reporting and Data System MRI risk score is a stratification system for assigning malignancy probability to adnexal lesions and can improve communication between radiologists an... MRI plays an important role as a secondary test or problem-solving modality in the evaluation of adnexal lesions depicted at US. MRI has increased specificity compared with US, decreasing the numbe...
In this study, the authors evaluated MR volumetry as a tool for the initial staging of endometrial cancer; when it was used as a quantitative biomarker, tumor volume allowed accurate prediction of deep myometrial invasion, tumor grade, and lymphovascular invasion. Purpose To investigate magnetic resonance (MR) volumetry of endometrial tumors and its association with deep myometrial invasion, tumor grade, and lymphovascular invasion and to assess the value of apparent diffusion coefficient (ADC) histographic analysis of the whole tumor volume for prediction of tumor grade and lymphovascular invasion. Materials and Methods The institutional review board approved this retrospective study; patient consent was not required. Between May 2010 and May 2012, 70 women (mean age, 64 years; range, 24–91 years) with endometrial cancer underwent preoperative MR imaging, including axial oblique and sagittal T2-weighted, dynamic contrast material–enhanced, and diffusion-weighted imaging. Volumetry of the tumor and uterus was performed during the six sequences, with manual tracing of each section, and the tumor volume ratio (TVR) was calculated. ADC histograms were generated from pixel ADCs from the whole tumor volume. The threshold of TVR associated with myometrial invasion was as...
Our preliminary results indicate that median apparent diffusion coefficient and slow diffusion coefficient values are useful for assessment of tumor response to combined chemotherapy and radiation therapy in rectal cancer and for discrimination between good and poor responders. PurposeTo determine the diagnostic performance of intravoxel incoherent motion (IVIM) parameters and apparent diffusion coefficient (ADC) to assess response to combined chemotherapy and radiation therapy (CRT) in patients with rectal cancer by using histogram analysis derived from whole-tumor volumes and single-section regions of interest (ROIs).Materials and MethodsThe institutional review board approved this retrospective study of 31 patients with rectal cancer who underwent magnetic resonance (MR) imaging before and after CRT, including diffusion-weighted imaging with 34 b values prior to surgery. Patient consent was not required. ADC, perfusion-related diffusion fraction (f), slow diffusion coefficient (D), and fast diffusion coefficient (D*) were calculated on MR images acquired before and after CRT by using biexponential fitting. ADC and IVIM histogram metrics and median values were obtained by using whole-tumor volume and single-section ROI analyses. All ADC and IVIM parameters obtained before and ...
MRI is integral to the evaluation and treatment of endometrial cancer, and contemporary multiparametric MRI plays a key role in pretreatment planning, therapy selection, radiation therapy guidance,... Created with BioRender.com Endometrial cancer is the second most common gynecologic cancer worldwide and the most common gynecologic cancer in the United States, with an increasing incidence in high-income countries. Althoug...