ABSTRACT
PURPOSE: To compose diagnostic standard operating procedures for both clinical and imaging assessment for vulvar and vaginal cancer, for vaginal sarcoma, and for ovarian cancer. METHODS: The literature was reviewed for diagnosing the above mentioned malignancies in the female pelvis. Special focus herein lies in tumor representation in MRI, followed by the evaluation of CT and PET/CT for this topic. CONCLUSION: MRI is a useful additional diagnostic complement but by no means replaces established methods of gynecologic diagnostics and ultrasound. In fact, MRI is only implemented in the guidelines for vulvar cancer. According to the current literature, CT is still the cross-sectional imaging modality of choice for evaluating ovarian cancer. PET/CT appears to have advantages for staging and follow-up in sarcomas and cancers of the ovaries.
Subject(s)
Genital Neoplasms, Female/diagnosis , Image Processing, Computer-Assisted/standards , Imaging, Three-Dimensional/standards , Magnetic Resonance Imaging/standards , Multimodal Imaging/standards , Positron-Emission Tomography , Tomography, X-Ray Computed , Female , Genital Neoplasms, Female/pathology , Genital Neoplasms, Female/radiotherapy , Guideline Adherence , Humans , Lymphatic Metastasis/diagnosis , Lymphatic Metastasis/pathology , Lymphatic Metastasis/radiotherapy , Neoplasm Invasiveness , Neoplasm Recurrence, Local/diagnosis , Neoplasm Recurrence, Local/pathology , Neoplasm Recurrence, Local/radiotherapy , Neoplasm Staging , Ovarian Neoplasms/diagnosis , Ovarian Neoplasms/pathology , Ovarian Neoplasms/radiotherapy , Prognosis , Radiotherapy Planning, Computer-Assisted , Sarcoma/diagnosis , Sarcoma/pathology , Sarcoma/radiotherapy , Sensitivity and Specificity , Tumor Burden , Ultrasonography/standards , Vaginal Neoplasms/diagnosis , Vaginal Neoplasms/pathology , Vulvar Neoplasms/diagnosis , Vulvar Neoplasms/pathology , Vulvar Neoplasms/radiotherapyABSTRACT
PURPOSE: To determine the effect of tissue perfusion on microwave ablation lesions in an experimental in vivo study in porcine kidneys. MATERIALS AND METHODS: Twelve kidneys of six pigs were studied. In each animal, two microwave ablations were created in one kidney without limitation of tissue perfusion (group 1). In the other kidney, two microwave ablations were performed with interruption of blood flow (group 2). All microwave ablations were performed with identical system parameters (eg, temperature control mode, ablation time of 80 s, and temperature of 110°C). The animals were euthanized 3 hours later. The kidneys were harvested and cut into 2-3-mm transverse slices. Microwave ablation zone dimensions (eg, length, width, and volume) and shape (eg, sphericity ratio) and corresponding variability were compared between groups. RESULTS: Microwave ablation areas were significantly longer (41.6 mm ± 4.0 vs 34.2 mm ± 5.9; P < .01) and wider (16.6 mm ± 1.2 vs 12.2 mm ± 2.1; P < .001) in group 2 than in group 1. Similarly, microwave ablation volume was significantly greater in group 2 compared with group 1 (6.7 cm(3) ± 1.0 vs 3.3 cm(3) ± 1.2; P < .001). Ablation area shapes were similar between groups (sphericity ratio, 2.57 ± 0.42 vs 2.39 ± 0.34). Ablation area variabilities were also comparable between groups (volume variance of 1.32 vs 0.93; sphericity ratio variance of 0.18 vs 0.11). CONCLUSIONS: After interruption of blood flow, microwave ablation areas are significantly larger than those achieved without limitation of tissue perfusion. Microwave ablation area shape and variability were comparable between study groups.
