Diagnosis of lymph node metastasis in uterine cervical cancer: usefulness of computer-aided diagnosis with comprehensive evaluation of MR images and clinical findings

作者：Kim Mi hyun; Kim Jeong Kon^*; Lee Youngjoo; Park Bum Woo; Lee Chang Kyung; Kim Namkug; Cho Gyunggoo; Choi Hyuck Jae; Cho Kyoung Sik

来源：Acta Radiologica, 2011, 52(10): 1175-1183.

DOI：10.1258/ar.2011.110202

• Uterine cervical neoplasm
• diffusion magnetic resonance imaging
• Bayesian prediction
• lymphatic metastasis
• lymph nodes

Background: Lymph node (LN) status is an important parameter for determining the treatment strategy and for predicting the prognosis for patients with uterine cervical cancer. Computer-aided diagnosis (CAD) can be feasible for differentiating metastatic from non-metastatic lymph nodes in patients with uterine cervical cancer
Purpose: To determine the usefulness of CAD that comprehensively evaluates MR images and clinical findings for detecting LN metastasis in uterine cervical cancer.
Material and Methods: In 680 LNs from 143 patients who underwent radical hysterectomy for uterine cervical cancer, the CAD system using the Bayesian classifier estimated the probability of metastasis based on MR findings and clinical findings. We compared the diagnostic accuracy for detecting metastatic LNs in the CAD and MR findings.
Results: Metastasis was diagnosed in 70 (12%) LNs from 34 (24%) patients. The area under ROC curves of CAD (0.924) was greater than those of the mean ADC (0.854), minimum ADC (0.849), maximum ADC (0.827), short-axis diameter (0.856) and long-axis diameter (0.753) (P < 0.05). The specificity and accuracy of the CAD (86%, 86%) were greater than those of the mean ADC (77%, 77%), maximum ADC (77%, 77%), minimum ADC (68%, 70%), and short-axis diameter (65%, 67%) (P < 0.05).
Conclusion: CAD system can improve the diagnostic performance of MR for detecting metastatic LNs in uterine cervical cancer.

• 出版日期2011-12