Search for Optimal MRI Protocol for the Diagnosis of Vaginal Tumor

Abstract

Background. A wide variety of pulse sequences, the possibility of multiplanar imaging significantly increase the capabilities of magnetic resonance imaging (MRI) in diagnosing diseases of the female reproductive system. At the same time, the lack of a regulated scanning protocol, especially in patients who have undergone anticancer treatment, requires standardization of the technique and the search for an optimal set of pulse sequences that allows to visualize the vagina throughout its entire length and to perform differential diagnosis between continued tumor growth and post-radiation changes while maintaining an adequate examination time.Objective: to determine the optimal set of MRI pulse sequences for pelvic organs examination in patients with vaginal tumors and to form an original research protocol based on diagnostic information content.Material and methods. The study included 141 patients with vaginal tumors. A comparative analysis of four MRI protocols was carried out, built according to the principle “from simple to complex” (from native to multiparametric MRI).Results. A significant difference was obtained between all information content indicators of Protocol 4 compared to Protocol 1 (sensitivity p = 0.00006, specificity p = 0.00443, AUC p = 0.00000). Data analysis also showed a significant difference between sensitivity and AUC for Protocols 2 and 4 (p = 0.00150 and p = 0.00087, respectively), and Protocols 3 and 4 (p = 0.01333 and p = 0.01333, respectively).Conclusion. Significant increase in the information content of Protocol 4 compared to other protocols (sensitivity up to 93%, specificity up to 94%, accuracy up to 93%) indicates the expediency of the priority use of multiparametric MRI in the primary diagnosis of vaginal tumor lesions.

Keywords

• vaginal tumor
• vaginal metastasis
• magnetic resonance imaging
• endovaginal mr-compatible applicator