关键词: Cervical cancer MRI brachytherapy diagnostic meta-analysis magnetic resonance imaging

Mesh : Brachytherapy / methods Cervix Uteri / diagnostic imaging Female Humans Magnetic Resonance Imaging / methods Sensitivity and Specificity Treatment Outcome Uterine Cervical Neoplasms / diagnostic imaging radiotherapy

来  源:   DOI:10.1177/0284185118791199

Abstract:
BACKGROUND: Patients with uterine cervical cancer suffer high mortality. Accurate detection of a residual tumor by magnetic resonance imaging (MRI) during and after directed brachytherapy (BCT) is crucial for the success of cancer treatment and is a significant predictor of patient survival.
OBJECTIVE: To determine the diagnostic significance of MRI in detecting residual tumor tissue after BCT.
METHODS: The Web of Knowledge, Cochrane Library, and PubMed were systematically searched (January 1997 to December 2016) for post-brachytherapy MRI studies that measured residual tumors in patients with uterine cervical cancer. All data were analyzed using the Meta-Disc 1.4 program.
RESULTS: Four clinical studies consisting of 163 patients (147 of whom were included in the present analysis) who were diagnosed with uterine cervical cancer according to the International Federation of Gynecology and Obstetrics (FIGO) staging system were included in the study. All the patients received BCT and underwent MRI detection of residual tumors tissue. In studies where the accuracy of MRI detection was confirmed by histological tests or gynecological tests, the summary estimates of specificity, sensitivity, positive predictive value, negative predictive value, and accuracy were 88.5%, 83.5%, 53.5%, 97.1%, and 84.3%, respectively.
CONCLUSIONS: MRI-directed BCT is commonly used for cervical cancer patients. Based on our investigation of four independent studies, MRI showed better prediction of positive results than negative results in patients with cervical cancer after BCT. However, more data on the greater numbers of patients are needed to establish the accuracy of MRI detection of cervical cancer after BCT.
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