Making the invisible visible: improving detectability of MRI-invisible residual cervical cancer after conisation by DCE-MRI

AIM: To determine whether dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) quantitative parameters increase the detectability of MRI-invisible residual cervical cancer after conisation. MATERIALS AND METHODS: This retrospective study included 59 patients with MRI-invisible cervical cancer, but positive conisation pathology. Thirty-five patients were confirmed to have residual cervical cancer, and 24 patients showed non-residual cervical cancer. DCE-MRI quantitative parameters were calculated in the anterior or posterior cervix according to the conisation position. Receiver operating characteristic (ROC) analysis was used to find the threshold of DCE-MRI parameters in differentiate residual cervical cancer patients from non-residual cervical cancer patients after conisation. RESULTS: For patients with residual cervical cancer, the K(trans )and V-e values were significantly higher than in their counterparts with non-residual cervical cancer (0.610 +/- 0.395 versus 0.366 +/- 0.305/min, p=0.013; and 0.703 +/- 0.270 versus 0.540 +/- 0.280%, p=0.028; respectively). The K-trans showed the highest area under the ROC curve (AUC) of 0.705 (p=0.004) with a sensitivity of 67.6% and specificity of 68%. CONCLUSION: DCE-MRI quantitative parameters increased the detectability of MRI-invisible residual cervical cancer after conisation. (C) 2018 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.