Magnetic resonance imaging prospects of prognostic value in women pelvic pathology

Abstract

Aim of the study was to estimate the prognostic value of perfusion and diffusion magnetic resonance imaging (MRI) methods in systemic evaluation of perifocal changes of malignant masses in women’s pelvis. Material and methods. A retrospective analysis of MRI of the pelvic organs in women was performed on MRI scanners with a magnetic field of 1.5 T (Philips Achieva, Netherlands). The retrospective study included 1,5 T MRI of 530 women with pelvis pathology. It consists of 50 % (265 cases) of malignant pelvic mass and 50 % (265 cases) of non tumor pathologies. The most common malignant pathologies were regarded: rectum cancer (n=61), ovarian cancer (n=62), uterine cancer (n=65), cervical cancer (n=77). Group with non-tumor pathology was taken as comparison group and included inflammation (abscess), adhesions and other non-tumor pelvic pathologies (pseudocyst of peritoneum, hemorrhagic cyst, endometriosis). In all cases a body coil was used on pelvic region. MRI protocols included T2-, T1 – weighted imaging, diffusion weighted imaging, postcontrast T1 - weighted imaging. apparent diffusion coefficient value and perfusion value were estimated. Results and discussion. In intergroup comparison with systemic evaluation of MRI with ANOVA we revealed that the diffusion restriction and the apparent diffusion coefficient bear potential value for disease prognosis. Conclusions. MRI can be of value not only for evaluation of local spread, as well as providing wide opportunities for differential diagnosis and use of MRI as biomarker in some diseases. Such indications as restricted diffusion, apparent diffusion coefficient value and type of dynamic curve from perifocal lesion can benefit disease prognosis.

Keywords

• magnetic resonance imaging
• uterine cervical cancer
• uterine corpus malignancy
• ovarian cancer
• rectal cancer
• prognosis