Comparison of ultrasound and MRI informativeness for detection and treatment monitoring of cervical cancer metastases in the vagina.

AIM: To assess ultrasound (US) method informativeness in the recurrence detection and treatment monitoring of patients with cervical cancer metastases in the vagina via comparing the US and magnetic resonance imaging (MRI) data. MATERIALS AND METHODS: 42 patients with recurrence of cervical cancer were examined by transvaginal US and MRI. Data on radiation diagnostics of cervical cancer metastasis in the vagina were compared with pathomorphological data. US and MRI data on the metastatic tumors size were compared. RESULTS: The diagnostic efficiency of US and MRI for recurrence detection was determined. The sensitivity, specificity and accuracy of US were 92.8; 93.3 and 93.3%, respectively, and of MRI - 95.2; 96.6 and 95.8%, respectively. The informativeness of MRI was higher than US in cervical cancer recurrences detection, but the difference was not significant (p > 0.05). US can provide data as informative as MRI for estimation of metastases sizes in the vagina. The mean difference between MRI measurements and US measurements of the metastases volume was 0.79 mm (95% CI 0.62-0.95 cm3). CONCLUSIONS: US as a cheaper and simpler method could be an alternative for metastases detecting and treatment monitoring, especially if there are contraindications to MRI.

BILATERAL AVASCULAR NECROSIS OF SACRAL LATERAL MASSES AFTER A COMPLETE RADIOLOGICAL RESPONSE OF LOCALLY ADVANCED RECTAL CANCER TREATED WITH NEOADJUVANT CHEMORADIATION THERAPY. CASE REPORT. / BILATERAL'NYY̆ AVASKULIaRNYY̆ NEKROZ LATERAL'NYKh MAS KRYZhIV PRY POVNOMU KLINIKO-RADIOLOGIChNOMU REGRESI PISLIa NEOAD'IuVANTNOÏ KhIMIOPROMENEVOÏ TERAPIÏ MISTsEVO POShYRENOGO DYSTAL'NOGO RAKU PRIaMOÏ KYShKY. KLINIChNYY̆ VYPADOK.

We present a rare case report of a bilateral avascular necrosis of lateral sacral masses in a patient who developed a sustainable complete clinical and radiological response after chemoradiotherapy for locally advanced rectal cancer. It is shown that despite the standardized and precise planning and fractioning for neoadjuvant chemoradiation therapy for locally advanced rectal cancer, the biological effects of ionizing radiation on critical organs can be va- ried both in time of occurrence and in structure. Evaluating the effect of neoadjuvant chemoradiation therapy, one should take into account the possibility of the development of even very rare effects of ionizing radiation on criti- cal organs and include their early detection in the diagnostic algorithm.

Radiation research to determine local tumor invasion in patients with cervical cancer.

The main task of radiation study of verified cervical cancer (CC) is tumor spread assessment because of its profound effect on the treatment tactics choice and prognosis. The Aim of the study was radiation study optimizing for tumor local spread assessment in patients with CC via comparing the usefulness of different magnetic resonance imaging (MRI) based approaches. MATERIALS AND METHODS: 62 patients with CC were examined by MRI on tomograph 1.5 Ð¢ using contrast enhancement and diffusion-weighted imaging (DWI). Pre-operation data on radiation diagnostics of tumor spread were compared with surgical and pathologic data. RESULTS: The diagnostic efficiency of different methods of radiation testing for assessment of local tumor spread in patients with CC was determined. The use of contrast enhancement didn't increase an informative value of МRI in assessment of local tumor spread. False overestimation of tumor spread was caused by intense accumulation of contrast substance around the tumor due to inflammation. Use of DWI allowed to reduce the number of false positive results, and significantly increased the efficiency of MRI (p < 0.05): the positive predictive value, sensitivity, specificity and accuracy were 83.3; 90.9; 96.0 and 95.1%, respectively. CONCLUSIONS: The use of DWI increases informativeness of МRI in assessment of local tumor spread.