Novel approaches to diagnostic imaging of locally advanced cervical cancer

N G Trukhacheva,E G Grigor’Ev,A V Usova,I G Frolova,L A Kolomiets,O N Churuksaeva,S A Velichko

doi:10.21294/1814-4861-2019-18-2-83-91

N G Trukhacheva, E G Grigor’Ev + Show 5 more

Open Access

https://doi.org/10.21294/1814-4861-2019-18-2-83-91

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Abstract

Cervical cancer is the second most common cancer after breast cancer and the third most common cause of cancer-related death followed by breast and lung cancers among women worldwide. advances in diagnostic imaging techniques provide better assessment of regional and distant cervical cancer metastasis. the use of contrast-enhanced ultrasound is a revolutionary imaging modality; it has several advantages over ct: no radiation exposure, nephrotoxicity, obtaining real-time information, relatively low cost and ease of use. currently, the contrast agent sonoVue is widely used in ultrasound imaging of liver, kidneys and pancreas lesions, as well as for closed abdominal injuries, multiple organ failure, breast and prostate cancers, etc. However, the role of contrast-enhanced ultrasound in gynecology is not clearly established. one of the most effective tools for the detection of locally advanced cervical cancer is mRi, which is used mainly to determine the local extent of the tumor. However, the use of functional mRitechniques has not yet been included in the standards. cervical cancer tissue has been found to show significantly lower diffusion-weighted imaging (dWi) values than normal cervical tissue, thus facilitating the detection of tumor and its spread. dWiis also used for differentiating changes after biopsy from residual tumor and for identifying small lymph nodes. the pEt/cttechnique combines the metabolic images of pEtwith anatomical images of ctand is more accurate than high resolution ctalone, especially in determining the involvement of regional lymph nodes and distant organs. 18-Fdg-pEt/cthas been successfully used for accurate staging of the disease (especially late stage), assessment of treatment response, radiotherapy planning, and detection of disease progression. in patients with advanced stages of cervical cancer (iiBiV stage), the 18-Fdg-pEt/ ctfindings can determine the treatment strategy in most cases, primarily due to high sensitivity (75–100 %) and specificity (87–100 %) in the detection of lymph node metastases.

Highlights

Роль УЗИ в диагностике местнораспространенного рака шейки матки Наиболее доступным и широко используемым методом диагностики является ультразвуковое исследование (УЗИ), выполняющееся на аппаратах экспертного класса
Cervical cancer is the second most common cancer after breast cancer and the third most common cause of cancer-related death followed by breast and lung cancers among women worldwide
The contrast agent SonoVue is widely used in ultrasound imaging of liver, kidneys and pancreas lesions, as well as for closed abdominal injuries, multiple organ failure, breast and prostate cancers, etc

Summary

Introduction

Роль УЗИ в диагностике местнораспространенного рака шейки матки Наиболее доступным и широко используемым методом диагностики является ультразвуковое исследование (УЗИ), выполняющееся на аппаратах экспертного класса. Рак шейки матки III–IV стадии диагностируется в 34,6 %, что является недопустимо высоким в диагностике новообразований визуальных локализаций, при этом смертность от РШМ остается высокой – приблизительно 150 000 случаев за год во всем мире, летальность в течение года с момента установления диагноза в 2016 г. Новые возможности УЗИ с применением контрастирования в диагностике местнораспространенного рака шейки матки Несмотря на повсеместное применение ультразвука в диагностике местнораспространенного РШМ, сохраняется потребность в разработке более четких критериев визуализации границ параметральной инвазии, распространения процесса на окружающие органы и стенки таза, метастазов в забрюшинные лимфатические узлы.

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