DIFFERENTIATION BETWEEN RECURRENT TUMOR AND BENIGN CONDITIONS AFTER TREATMENT OF GYNECOLOGIC PELVIC CARCINOMA - VALUE OF DYNAMIC CONTRAST-ENHANCED SUBTRACTION MR-IMAGING

PURPOSE: To compare dynamic contrast material-enhanced subtraction and T2-weighted spin-echo (SE) magnetic resonance (MR) imaging in the dif ferentiation of fibrosis from tumor recurrence during the followup of treated gynecologic pelvic malignaney. MATERIALS AND METHODS: Thirty-f our patients (aged 24-82 years) with 18 benign and 35 malignant lesion s confirmed by means of surgery (n = 18), biopsy (n = 25), or 18-month follow-up examination (n = 10) underwent dynamic contrast-enhanced su btraction and T2-weighted SE MR imaging. Contrast material enhancement of an abnormal pelvic structure within the first 90 seconds on dynami c contrast-enhanced subtraction images or high signal intensity on T2- weighted SE images was considered indicative of malignancy. RESULTS: T he sensitivity, specificity, accuracy, and positive and negative predi ctive values were 91%, 67%, 83%, 86%, and 86%, respectively, for dynam ic contrast-enhanced subtraction imaging and 91%, 22%, 68%, 70%, and 5 7%, respectively, for T2-weighted SE imaging. More lesions were correc tly classified with dynamic contrast-enhanced subtraction imaging than with TP-weighted SE imaging (P < .01). CONCLUSION: Dynamic contrast-e nhanced subtraction imaging is more accurate than T2-weighted SE imagi ng for differentiating fibrosis from tumor recurrence during the follo w-up of treated gynecologic pelvic malignancy. However, use of both se quences is recommended.