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Imaging of Gynecologic and Genitourinary Malignancies

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A special issue of Cancers (ISSN 2072-6694).

Deadline for manuscript submissions: closed (31 January 2021) | Viewed by 21752

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Special Issue Editor

Dr. Dhakshinamoorthy Ganeshan

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Guest Editor

Department of Abdominal Imaging, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
Interests: gynecologic cancer imaging; genitourinary cancer imaging; comparative effectiveness and research; health services research and policy

Special Issue Information

Dear Colleagues,

Imaging plays a vital role in the management of various gynecologic and genitourinary malignancies. Over the past few decades, significant advances have been made in imaging technology. Apart from diagnosis and staging, imaging has become critical for deciding management and in prognostication. This Special Issue provides a comprehensive overview of the role of computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, positron emission tomography/computed tomography (PET/CT), and positron emission tomography/magnetic resonance (PET/MR) in gynecologic and genitourinary malignancies. In addition, the relevance of radiogenomics and radiomics in these tumors will be discussed, where appropriate. A current update on the pathology, molecular cytogenetics, and management of these tumors will be provided.

Dr. Dhakshinamoorthy Ganeshan
Guest Editor

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Keywords

ovarian malignancies
endometrial malignancies
cervical malignancies
vaginal and vulvar malignancies
prostate malignancies
renal malignancies
bladder and urothelial malignancies
testicular malignancies

Published Papers (3 papers)

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Research

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15 pages, 3466 KiB

Open AccessArticle

Computer-Aided Segmentation and Machine Learning of Integrated Clinical and Diffusion-Weighted Imaging Parameters for Predicting Lymph Node Metastasis in Endometrial Cancer

by Lan-Yan Yang, Tiing Yee Siow, Yu-Chun Lin, Ren-Chin Wu, Hsin-Ying Lu, Hsin-Ju Chiang, Chih-Yi Ho, Yu-Ting Huang, Yen-Ling Huang, Yu-Bin Pan, Angel Chao, Chyong-Huey Lai and Gigin Lin

Cancers 2021, 13(6), 1406; https://doi.org/10.3390/cancers13061406 - 19 Mar 2021

Cited by 22 | Viewed by 2610

Abstract

Precise risk stratification in lymphadenectomy is important for patients with endometrial cancer (EC), to balance the therapeutic benefit against the operation-related morbidity and mortality. We aimed to investigate added values of computer-aided segmentation and machine learning based on clinical parameters and diffusion-weighted imaging radiomics for predicting lymph node (LN) metastasis in EC. This prospective observational study included 236 women with EC (mean age ± standard deviation, 51.2 ± 11.6 years) who underwent magnetic resonance (MR) imaging before surgery during July 2010–July 2018, randomly split into training (n = 165) and test sets (n = 71). A decision-tree model was constructed based on mean apparent diffusion coefficient (ADC) value of the tumor (cutoff, 1.1 × 10⁻³ mm²/s), skewness of the relative ADC value (cutoff, 1.2), short-axis diameter of LN (cutoff, 1.7 mm) and skewness ADC value of the LN (cutoff, 7.2 × 10⁻²), as well as tumor grade (1 vs. 2 and 3), and clinical tumor size (cutoff, 20 mm). The sensitivity and specificity of the model were 94% and 80% for the training set and 86%, 78% for the independent testing set, respectively. The areas under the receiver operating characteristics curve (AUCs) of the decision-tree was 0.85—significantly higher than the mean ADC model (AUC = 0.54) and LN short-axis diameter criteria (AUC = 0.62) (both p < 0.0001). We concluded that a combination of clinical and MR radiomics generates a prediction model for LN metastasis in EC, with diagnostic performance surpassing the conventional ADC and size criteria. Full article

(This article belongs to the Special Issue Imaging of Gynecologic and Genitourinary Malignancies)

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15 pages, 9863 KiB

Open AccessArticle

Systematic Review and Meta-Analysis of Vesical Imaging-Reporting and Data System (VI-RADS) Inter-Observer Reliability: An Added Value for Muscle Invasive Bladder Cancer Detection

by Francesco Del Giudice, Martina Pecoraro, Hebert Alberto Vargas, Stefano Cipollari, Ettore De Berardinis, Marco Bicchetti, Benjamin I. Chung, Carlo Catalano, Yoshifumi Narumi, James W. F. Catto and Valeria Panebianco

Cancers 2020, 12(10), 2994; https://doi.org/10.3390/cancers12102994 - 15 Oct 2020

Cited by 52 | Viewed by 3206

Abstract

The Vesical Imaging-Reporting and Data System (VI-RADS) has been introduced to provide preoperative bladder cancer staging and has proved to be reliable in assessing the presence of muscle invasion in the pre-TURBT (trans-urethral resection of bladder tumor). We aimed to assess through a systematic review and meta-analysis the inter-reader variability of VI-RADS criteria for discriminating non-muscle vs. muscle invasive bladder cancer (NMIBC, MIBC). PubMed, Web of Science, Cochrane, and Embase were searched up until 30 July 2020. The Quality Appraisal of Diagnostic Reliability (QAREL) checklist was utilized to assess the quality of included studies and a pooled measure of inter-rater reliability (Cohen’s Kappa [κ] and/or Intraclass correlation coefficients (ICCs)) was calculated. Further sensitivity analysis, subgroup analysis, and meta-regression were conducted to investigate the contribution of moderators to heterogeneity. In total, eight studies between 2018 and 2020, which evaluated a total of 1016 patients via 21 interpreting genitourinary (GU) radiologists, met inclusion criteria and were critically examined. No study was considered to be significantly flawed with publication bias. The pooled weighted mean κ estimate was 0.83 (95%CI: 0.78–0.88). Heterogeneity was present among the studies (Q = 185.92, d.f. = 7, p < 0.001; I2 = 92.7%). Meta-regression analyses showed that the relative % of MIBC diagnosis and cumulative reader’s experience to influence the estimated outcome (Coeff: 0.019, SE: 0.007; p= 0.003 and 0.036, SE: 0.009; p = 0.001). In the present study, we confirm excellent pooled inter-reader agreement of VI-RADS to discriminate NMIBC from MIBC underlying the importance that standardization and reproducibility of VI-RADS may confer to multiparametric magnetic resonance (mpMRI) for preoperative BCa staging. Full article

(This article belongs to the Special Issue Imaging of Gynecologic and Genitourinary Malignancies)

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Review

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22 pages, 5671 KiB

Open AccessReview

Imaging and Management of Bladder Cancer

by Vincenzo K. Wong, Dhakshinamoorthy Ganeshan, Corey T. Jensen and Catherine E. Devine

Cancers 2021, 13(6), 1396; https://doi.org/10.3390/cancers13061396 - 19 Mar 2021

Cited by 31 | Viewed by 15414

Abstract

Methods: Keyword searches of Medline, PubMed, and the Cochrane Library for manuscripts published in English, and searches of references cited in selected articles to identify additional relevant papers. Abstracts sponsored by various societies including the American Urological Association (AUA), European Association of Urology (EAU), and European Society for Medical Oncology (ESMO) were also searched. Background: Bladder cancer is the sixth most common cancer in the United States, and one of the most expensive in terms of cancer care. The overwhelming majority are urothelial carcinomas, more often non-muscle invasive rather than muscle-invasive. Bladder cancer is usually diagnosed after work up for hematuria. While the workup for gross hematuria remains CT urography and cystoscopy, the workup for microscopic hematuria was recently updated in 2020 by the American Urologic Association with a more risk-based approach. Bladder cancer is confirmed and staged by transurethral resection of bladder tumor. One of the main goals in staging is determining the presence or absence of muscle invasion by tumor which has wide implications in regards to management and prognosis. CT urography is the main imaging technique in the workup of bladder cancer. There is growing interest in advanced imaging techniques such as multiparametric MRI for local staging, as well as standardized imaging and reporting system with the recently created Vesicle Imaging Reporting and Data System (VI-RADS). Therapies for bladder cancer are rapidly evolving with immune checkpoint inhibitors, particularly programmed death ligand 1 (PD-L1) and programmed cell death protein 1 (PD-1) inhibitors, as well as another class of immunotherapy called an antibody-drug conjugate which consists of a cytotoxic drug conjugated to monoclonal antibodies against a specific target. Conclusion: Bladder cancer is a complex disease, and its management is evolving. Advances in therapy, understanding of the disease, and advanced imaging have ushered in a period of rapid change in the care of bladder cancer patients. Full article

(This article belongs to the Special Issue Imaging of Gynecologic and Genitourinary Malignancies)

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