Table 1.
Comparison of three protocols for diagnosing intra-pelvic recurrence on a per patient basis.
Fig 1.
ROC curves for protocol A (red), protocol B (green), and protocol C (blue) in depicting (a) local recurrence, (b) intrapelvic lymph node recurrence, (c) intrapelvic peritoneal dissemination, and (d) intrapelvic recurrence on a per-patient basis.
(a) The AUCs calculated for protocol B (0.881) and protocol C (0.892) were significantly higher than that for protocol A (0.800). (b) The AUC calculated for protocols B and C (0.927) was not significantly higher than that for protocol A (0.902). (c) The AUCs calculated for protocol B (0.924) and protocol C (0.931) were significantly higher than that for protocol A (0.885). (d) The AUCs calculated for protocol B (0.838) and protocol C (0.862) were significantly higher than that for protocol A (0.753).
Fig 2.
A 54-year-old woman with a locally recurrent tumor 10 months after surgery for uterine cervical cancer.
(a) Axial T2-weighted MRI shows a small, slightly hyperintense area in the vaginal vault (arrow). This equivocal finding for local recurrence was assigned a score of 3 for protocol A. (b) Axial DWI shows a focal hyperintense area in the posterior urinary bladder (arrow), corresponding to the area seen in (a), suggesting local recurrence. Protocol B was assigned a score of 5 for local recurrence. (c) Axial contrast-enhanced MRI shows abnormal enhancement as the same site (arrow), suggesting local recurrence. The score assigned for protocol C was 5. Biopsy confirmed the presence of tumor recurrence.
Fig 3.
A 65-year-old woman with intrapelvic lymph node recurrence 12 months after surgery for endometrial cancer.
(a) Axial T2-weighted MRI shows a 9-mm left external iliac LN (arrow). This equivocal finding for lymph node recurrence was assigned a score of 3 for protocol A. (b) Axial DWI shows a focal hyperintense spot in the left external iliac area (arrow), corresponding to the node seen in (a), being suspicious for lymph node recurrence. The score assigned for protocol B was 4. (c) Axial contrast-enhanced MRI shows slight ring-like enhancement of the same node (arrow), suggesting lymph node recurrence. The score assigned for protocol C was 4. Follow-up MRI showed an increase in the size of this node, confirming lymph node recurrence.