Abstract
Objectifs To compare the performance of Sinerem®-enhanced MRI with unenhanced MRI for nodal staging. Materiels et methodes 271 patients (mean age 61) with prostate (116), uterus (109), bladder (49) cancers and ambiguous clinical nodal status, were enrolled. MRI (1T/1.5T) was performed before and 24-36 hours after Sinerem® (slow IV infusion, 2,6 mg Fe/kg), maximum 2 weeks before lymphadenectomy. Imaging was standardized (axial Tl/PD-w, axial and para-sagittal T2*-wGRE sequences, 5 mm-slice thickness, 0.5 mm-interslice gap). Three off-site blinded readings were performed. Resultats Histopathology showed metastatic nodes for 68 patients (26.6 %), with 328 nodes individually correlated between MRI and histopathology (17.5% metastatic). Pre+post-Sinerem® sensitivity was higher than pre-contrast sensitivity, highly significantly for 2 readers (> 22 %, p Conclusion In pelvic cancer patients with ambiguous nodal status, Sinerem®-enhanced MRI demonstrates higher sensitivity than unenhanced MRI for diagnosing lymph node metastases, with similar high specificity and higher NPV. This may contribute to better patient management. Post-Sinerem® images are sufficient for nodal assessment.
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