The informative value of magnetic resonance imaging with the application of the protocol of diffusion-weighted images in the assessment of the endometrium when multiple neoplasias

Purpose of the study. To study the diagnostic informativeness of magnetic resonance imaging (MRI) with the assessment of diffusion- weighted images and the measured diffusion coefficient in the diagnosis of endometrial tumor lesions in polyineoplasias.

Materials and methods. The article presents the results of a study of patients with synchronous and metachronous polyneoplasias who were in the AU "Republican clinical oncological dispensary" of the Ministry of health of the Chuvash Republic from 2014 to 2018. All were performed magnetic resonance imaging on Excelart Vantage Atlas (Toshiba, Japan, 1.5 T), ultrasound (Aplio, Xario and Nemio, Toshiba, Japan; Sono Scape, China), x-ray computed tomography on Light Speed VEX Plus and Light Speed RT 16 (GE, USA). All MRI results were compared with morphological data obtained after
histomorphological examination of the postoperative material. The differences were considered significant at values p≤0.05.

Results. 80 cases of endometrial tumor lesions in polyineoplasias (N1a) were detected, which was 44.7% of all cases of the main group (N1; n=179), of which metachronous polyineoplasias were found in 56 (70.0%), synchronous — in 11 (13.7%), combined — in 13 (16.3%) patients. The informative value of MRI in the diagnosis of malignant neoplasms with lesions of the endometrium when multiple neoplasias were: sensitivity of 91.3%, specificity — 82,4%, accuracy was 89.7% (p<0.001).

Conclusions. Magnetic resonance imaging using the diffusion- weighted image Protocol with an assessment of the measured diffusion coefficient has shown high information both in the diagnosis of primary endometrial tumor lesions in primary multiple malignancies, and in establishing the stage of the tumor process and in the diagnosis of subsequent malignancies.

1. Rubtsova NA, Novikova EG, Sinitsyn VE. Role of diffusion-weighted magnetic resonance imaging in the diagnosis of uterine cancer relapsed. Radiology-Practice. 2012;(4):41–54. (in Russian).

2. Hricak H, Oguz A, Sala E. Diagnostic imaging: Gynecology. Amirsys, 2007, 830 p.

3. Safonova MA, Diomidova VN, Zakharova OV, Ionov AM, Siordiya A.A. Affection of female reproductive organs in the structure of multiple primary malignant neoplasms. Gynecology, Obstetrics and Perinatology. 2016;15(3):48–53. (in Russian).

4. The status of cancer treatment for the population of Russia in 2017. Ed. by A.D.Kaprin, V.V.Starinsky, G.V.Petrova. Moscow: MNIOI named after P.A. Gertzen – a Branch of the Federal State Budgetary Institution Scientific Research Center for Radiology of the Ministry of Health of Russia, 2018, 236. (In Russian).

5. The status of cancer treatment for the population of Russia in 2018. Ed. by A.D.Kaprin, V.V.Starinsky, G.V.Petrova. Moscow: MNIOI named after P.A. Gertzen – a Branch of the Federal State Budgetary Institution Scientific Research Center for Radiology of the Ministry of Health of Russia, 2019, 236. (In Russian).

6. Aksel E. M., Davydov M. I. statistics of morbidity and mortality from malignant neoplasms in 2000. Malignant neoplasms in Russia and CIS countries in 2000. Moscow: N.N. Blokhin Russian Cancer Research Center, 2012, 85-106 p. (in Russian).

7. Makhovskii VZ, Yurin SV, Makhovskii VV. Synchronous primary multiple malignancies of colon and ovary followed by acute intestinal obstruction. Surgery. Journal named after N.I.Pirogov. (in Russian). 2016;4:67–69. https://doi.org/10.17116/hirurgia2016467-69

8. Chudina AP, Lvov AA, Krutikova IP, Nekrasova EA, Savluchinskaya LA. Primary multiple malignant neoplasms with a family history of cancer. Oncology. Journal named after P.A.Herzen. 2017;6(2):29–32. https://doi.org/10.17116/onkolog20176229-32

9. Stepanova YuA, Kalinin DV, Vishnevsky VA. Multiple Primary Neoplasms (Literature Review). Medical Visualization. 2015;(6):93–102. (in Russian).

10. Payanidi YuG, Zhordaniya KI, Pauker V, Selchuk VYu, Kazubskaya TP. Primary Multiple Malignant Neoplasms Bodies Reproductive System and Colon in Women. Journal of N.N. Blokhin Russian Cancer Research Center. 2016;27(2):108–112. (in Russian).

11. Rubtsova NA, Novikova EG. Errors of magnetic resonance imaging in the diagnosis of cervical and endometrial cancer. Diagnostic Radiology and Radiotherapy. 2013;(3):71–76.

12. Rubtsova NA, Novikova EG, Sinitsin VE, Vostrov AN, Stepanov SO. Endometrial cancer: Preoperative staging. The informative value of ultrasound study versus magnetic resonance imaging. Journal of Radiology and Nuclear Medicine. 2012;(4):33–41. (in Russian).

13. Zandrino F, La Paglia E, Musante F. Magnetic resonance imaging in local staging of endometrial carcinoma: diagnostic performance, pitfalls, and literature review. Tumori. 2010 Aug;96(4):601–608.

14. Yahata T, Aoki Y, Tanaka K. Prediction of myometrial invasion in patients with endometrial carcinoma: comparison of magnetic resonance imaging, transvaginal ultrasonography, and gross visual inspection. Eur J Gynaecol Oncol. 2007;28(3):193–195.

15. Padhani DM, Padhani AR, Collins DJ. Technology insight: water diffusion MRI – a potential new biomarker of response to cancer therapy. Nat Clin Pract Oncol. 2008 Apr;5(4):220–233. https://doi.org/10.1038/ncponc1073

16. Heunser T-A, Kuemmel S, Koeninger A, Hamami ME, Hahn S, Quinsten A, et al. Diagnostic value of diffusion-weighted magnetic resonance imaging (DWI) compared to FDG PET/CT for whole-body breast cancer staging. Eur J Nucl Med Mol Imaging. 2010 Jun;37(6):1077–1086. https://doi.org/10.1007/s00259-010-1399-z

17. Ikeda Y, Saku M, Kishihara F, Maehara Y. Effective follow-up for recurrence or a second primary cancer in patients with early gastric cancer. Br J Surg. 2005 Feb;92(2):235–239. https://doi.org/10.1002/bjs.4758

18. Wu C-W, Lo S-S, Chen J-H, Hsieh M-C, Li AFY, Lui W-Y. Multiple primary cancers in patients with gastric cancer. Hepatogastro-enterology. 2006 Jun;53(69):463–467.

19. Safonova MA, Diomidova VN. Comprehensive radiation diagnosis of tumor lesion of pelvic organs in synchronous polyneoplasia. Current trends in the development of science and technology. 2015;(6-4):88–90. (in Russian).

20. Kutalia PZ, Selchuk VYu, Payanidi YuG, Zhordania KI, Shelepova VM, Zakharova TI. Ovarian malignancies and polyneoplasias: clinical presentation, diagnosis, mechanisms of development, prognosis. Tumors of Female Reproductive System. 2011;(1):80– 85. (in Russian). https://doi.org/10.17650/1994-4098-2011-0-1-80-85

21. Zhuk EG, Kosenko IA, Dudarev VS, Karman AV, Vasilevsky AP, Shimanets SV. Determining the sequence of integrated radiation diagnostic methods in assessing the prevalence of endometrial cancer. In: Topical issues of diagnosis and treatment of malignant neoplasms: collection of scientific works REP. scientific-practical Conf., dedicated. 40th anniversary of the caf. oncologies. Under the General editorship of A.V. Prokhorov. Minsk: Belarusian state medical University, 2014, 30–31 p. (in Russian).

22. Kaprin AD, Galkin VN, Zhavoronkov LP, Ivanov VK, Ivanov SA, Romanko YuS. Synthesis of fundamental and applied research the basis for ensuring a high level of scientific results and their implementation in medical practice. Radiation and risk. 2017;26(2):26–40. https://doi.org/10.21870/0131-3878-2017-26-2-26-40.

23. Petsuksiril J, Jaishuen A, Pattaranutaporn P, Chansilpa Y. Advanced imaging applications for locally advanced cervical cancer. Asian Pac J Cancer Prev. 2012;13(5):1713–1718. https://doi.org/10.7314/apjcp.2012.13.5.1713