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ASSESSMENT OF PROGNOSTIC SIGNIFICANCE OF DIFFUSION PARAMETERS BASED ON MAGNETIC RESONANCE IMAGING OF PELVIC CANCER IN WOMEN

 

Bergen T.A.1, Fokin V.A.2, Pustovetova M.G., SoynovI.A.1,

Chernyavskiy A.M.1, Trufanov G.E.2

Purpose. To estimate the prognostic significance of diffusion parameters of magnetic resonance imaging (MRI) results in the treatment of pelvic cancer in women.

Materials and methods. Retrospective MRI study of 530 patients using Propensity score matching (PSM). The patients were divided into 2 groups: a group of malignant tumor pathology of pelvic organs and a comparison group. After PSM, 165 people remained in both groups. The observation period for the patients ranged from 2 to 7 years.

Results. Presence of perifocal infiltration (PI) decreases the likelihood of recovery: OR 0.06 (CI 0.02; 0.16). In ovarian cancer high PI ADC values increase the probability of aggravation (OR 7.9, CI 1.8; 34), p = 0.005; ROC-analysis showed the cut-off value 0.7 х 10-3 mm2/sec (sensitivity 93.7 %, specificity 52.1 %), area under the curve 0.8 (CI 0,67; 0,94), p = 0.048. In endometrial cancer PI ADC values increased the probability of aggravation (OR 5.9, CI 1.1; 31), p = 0.034, cut-off value 0.3 х 10-3 mm2/sec (sensitivity – 88.7%, specificity – 54.8%), area under the curve 0.73 (CI 0.55; 0.92), p = 0.042. In cervical cancer PI ADC values increased the probability of aggravation (OR 9.4, CI 1.5; 60), p = 0.016, cut-off value 1.1 х 10-3 mm2/sec (sensitivity – 80.3%, specificity – 52.2%), area under the curve 0.82 (CI 0.54; 0.99), p = 0.047. In rectal cancer impact of PI ADC values on the course of disease has not been found.

Conclusion. Presence of PI with diffusion limitation is prognostically unfavorable. A personalized systematic approach to MRI allows prognostic assessment of the disease course.

 

1 - Meshalkin National Medical Research Centre. Novosibirsk, Russia.

2 - Almazov National Medical Research Centre. Sankt-Petersburg, Russia.

Keywords: MRI, DWI, ADC, oncology, rectum, gynecology.

 


Corresponding author:  Tatyana Bergen, e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: Bergen T.A., Fokin V.A., Pustovetova M.G., SoynovI.A., Chernyavskiy A.M., Trufanov G.E. Assessment of prognostic significance of diffusion parameters based on magnetic resonance imaging of pelvic cancer in women. REJR 2022; 12(1):67-79. DOI: 10.21569/2222-7415-2022-12-1-67-79.

Received: 20.08.21                 Accepted:       23.12.21