图像在宫癌分期中的作用:ESGO/ESTRO/ESP指南 (2023年更新)
Daniela Fischerova1, Filip Frühauf1, Andrea Burgetova2
1Gynecologic Oncology Centre, Department of Gynaecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University and General University Hospital in Prague, 121 08 Prague, Czech Republic.
Cancers
|February 24, 2024
概括
现代成像技术,包括经阴道/经直肠超声波 (TVS/TRS) 和MRI,指导宫癌的治疗. 虽然对瘤扩散和淋巴结的确切,但需要进一步的成像,如CT或PET-CT,以评估远程传播.
科学领域:
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
- 病理学 病理学 病理学
背景情况:
- 欧洲妇科瘤学会 (ESGO),欧洲放射治疗和瘤学会 (ESTRO) 和欧洲病理学会 (ESP) 的指导方针强调用于宫癌管理的现代成像.
- 更新的2023年建议重申了先进成像技术的重要性.
研究的目的:
- 审查支持诊断成像,特别是超声波的证据,用于宫癌的初级检查.
- 根据当前的指导方针,强调成像在治疗决策中的作用.
主要方法:
- 审查当前的欧洲妇科瘤学会 (ESGO),欧洲放射治疗和瘤学会 (ESTRO) 和欧洲病理学会 (ESP) 准则 (2018年和2023年更新).
- 分析通过阴道/直肠超声波 (TVS/TRS) 和盆腔磁共振成像 (MRI) 对于瘤划界和局部范围评估的实用性.
- 评估对比度增强计算机断层扫描 (CECT) 和18F-氧葡萄糖正子发射断层扫描与CT (PET-CT) 结合用于额外骨盆传播评估的作用.
主要成果:
- 经阴道/直肠超声波 (TVS/TRS) 和盆腔MRI精确地划定瘤,并评估局部侵袭,包括膀/直肠壁透.
- 这些模式对转移的盆腔淋巴结具有很高的特异性,但对小体积转移的敏感性有限.
- 对于TVS/TRS或MRI上阴性淋巴结的早期疾病,建议进行外科病理学分期.
- 在其他情况下,建议使用CET或PET-CT来评估骨盆外传播.
结论:
- 诊断成像,特别是超声波,对于宫癌的初级检查至关重要.
- 多模式成像方法,结合超声波,核磁共振和潜在的CT/PET-CT,对于准确的分期和指导治疗决策至关重要.
- 目前的指导方针强烈支持将先进的成像技术纳入宫癌管理中.
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