Evaluation of the indications for performing magnetic resonance imaging of the female pelvis at a referral center for cancer, according to the American College of Radiology criteria.

Camila Silva Boaventura,Olimpio Antonio Cornehl Silva,Daniel Padilha Rodrigues,Rayssa Araruna Bezerra De Melo,Rubens Chojniak,Almir Galvão Vieira Bitencourt,Fabrício Henrique Beltrani,Gustavo Gomes Mendes

doi:10.1590/0100-3984.2015.0123

Camila Silva Boaventura, Olimpio Antonio Cornehl Silva + Show 6 more

Open Access

https://doi.org/10.1590/0100-3984.2015.0123

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Journal: Radiologia brasileira	Publication Date: Feb 1, 2017
Citations: 6	License type: cc-by

Affiliation: AC Camargo Hospital

Abstract

ObjectiveTo evaluate the indications for performing magnetic resonance imaging of the female pelvis at a referral center for cancer.Materials and MethodsThis was a retrospective, single-center study, conducted by reviewing medical records and imaging reports. We included 1060 female patients who underwent magnetic resonance imaging of the pelvis at a cancer center between January 2013 and June 2014. The indications for performing the examination were classified according to the American College of Radiology (ACR) criteria.ResultsThe mean age of the patients was 52.6 ± 14.8 years, and 49.8% were perimenopausal or postmenopausal. The majority (63.9%) had a history of cancer, which was gynecologic in 29.5% and nongynecologic in 34.4%. Of the patients evaluated, 44.0% had clinical complaints, the most common being pelvic pain (in 11.5%) and bleeding (in 9.8%), and 34.7% of patients had previously had abnormal findings on ultrasound. Most (76.7%) of the patients met the criteria for undergoing magnetic resonance imaging, according to the ACR guidelines. The main indications were evaluation of tumor recurrence after surgical resection (in 25.9%); detection and staging of gynecologic neoplasms (in 23.3%); and evaluation of pelvic pain or of a mass (in 17.1%).ConclusionIn the majority of the cases evaluated, magnetic resonance imaging was clearly indicated according to the ACR criteria. The main indication was local recurrence after surgical treatment of pelvic malignancies, which is consistent with the routine protocols at cancer centers.

Highlights

We evaluated female patients who underwent Magnetic resonance imaging (MRI) of the pelvis between January 2013 and June 2014 at a referral center for cancer
The results of the present study demonstrate that, for the majority of the pelvic MRI scans evaluated in the present study, the indication for the examination was appropriate according to the American College of Radiology (ACR) criteria
In our sample of female patients treated at a referral center for cancer, the main indication for MRI was the evaluation of post-treatment tumor recurrence, followed by the diagnosis and staging of gynecologic tumors

Summary

Introduction

Boaventura CS et al / Magnetic resonance imaging of the female pelvis: indications a paramagnetic contrast agent (gadolinium). MRI can provide morphological information such as size, contours, number of lesions, edema, necrosis, relationship to adjacent structures, physiological alterations, and cellular metabolism, allowing a more complete evaluation in terms of disease distribution and activity. MRI applied to gynecology offers additional information on the anatomy of the female pelvis in comparison with other imaging modalities, such as ultrasound and computed tomography (CT). Non-oncologic indications for MRI of the female pelvis include inconclusive pelvic ultrasound examination, evaluation of postoperative complications, pelvic pain, malformations of the vagina or uterus, and pelvic floor defect[12,13,14,15,16,17]. The American College of Radiology (ACR) compiled these indications into an educational guide and guideline for clinical decision-making in medical practice[18]

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