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Accuracy of Magnetic Resonance Imaging in Pretreatment Lymph Node Assessment for Gynecological Malignancies

  • Sufian, Saira Naz (Department of Diagnostic Radiology, The Aga Khan University Hospital Karachi) ;
  • Masroor, Imrana (Department of Diagnostic Radiology, The Aga Khan University Hospital Karachi) ;
  • Mirza, Waseem (Department of Diagnostic Radiology, The Aga Khan University Hospital Karachi) ;
  • Hussain, Zainab (Department of Diagnostic Radiology, The Aga Khan University Hospital Karachi) ;
  • Hafeez, Saima (Department of Diagnostic Radiology, The Aga Khan University Hospital Karachi) ;
  • Sajjad, Zafar (Department of Diagnostic Radiology, The Aga Khan University Hospital Karachi)
  • Published : 2014.06.15

Abstract

Objective: To determine the accuracy of magnetic resonance imaging (MRI) in detection of metastasis in pelvic and para-aortic lymph nodes from different gynecological malignancies. Materials and Methods: This retrospective cross sectional analytic study was conducted at the Department of Diagnostic Radiology, Aga Khan University Hospital Karachi Pakistan from January 2011 to December 2012. A sample of 48 women, age range between 20-79 years, fulfilling inclusion criteria were included. All patients had histopathologically proven gynecological malignancies in the cervix, endometrium or ovary and presented for a pretreatment MRI to our radiology department. Results: MRI was 100% sensitive and had a 100% positive predictive value to detect lymph node metastasis in lymph nodes with spiculated margins and 100% sensitive with a 75% positive predictive value to detect lymph node metastasis in a lymph node with lobulated margins. The sensitivity and positive predictive value of MRI to detect heterogeneous nodal enhancement were 100% and 75% respectively. Conclusions: Our study results reinforce that MRI should be used as a modality of choice in the pretreatment assessment of lymph nodes in proven gynaecological malignancies in order to determine the line of patientmanagement, distinguishing surgical from non-surgical cases.

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