Uloga magnetske rezonancije u dijagnostici ranog stadija karcinoma vrata maternice

master's thesis

• Title (english): Role of MRI in the diagnosis of early-stage cervical carcinoma
• Author: Berislav Tkalčić
• Mentor: Maja Prutki (mentor)
• Committee member: Maja Hrabak Paar (predsjednik povjerenstva)
• Committee member: Gordana Ivanac (član povjerenstva)
• Committee member: Maja Prutki (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Radiology); Zagreb
• Defense date and country: 2020-07-17, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Radiology

Abstract

Karcinom vrata maternice zloćudna je bolest epitelnih stanica endocerviksa ili egzocerviksa. Povezana je s infekcijom Humanim Papiloma Virusom. Četvrta je najzastupljenija maligna bolest u žena u svijetu, dok se u Hrvatskoj nalazi na 21. mjestu. Razvijene zemlje svjedoče padu incidencije karcinoma vrata maternice, no ova je bolest i dalje teret zdravstvenih sustava zemalja u razvoju. Procjena progresije bolesti do 2018. godine bazirala se većinom na podacima dobivenim kliničkim pregledom. Međutim, magentska rezonancija zbog svoje mogućnosti mekotkivnog razlučivanja, uvrštena je u protokol određivanja stadija. Brojne studije uspoređivale su dosadašnju praksu utvrđivanja stadija kliničkim putem i određivanja stadija magnetskom rezonancijom. Utvrđeno je kako se magnetskom rezonancijom dobivaju precizniji podaci o napretku bolesti na temelju kojih je moguće optimalizirati daljnji terapijski plan. Magnetska rezonancija indicirana je prilikom postavljanja stadija IB ili višeg, u slučaju preoperacijske obrade pacijentica kandidatkinja za poštednu operaciju te se također koristi u sustavu praćenja odgovora na terapiju i eventualnog povratka bolesti. Magnetskom se rezonancijom u T2 sekvencama karcinom vrata maternice prikazuje kao tvorba srednjeg do visokog intenziteta signala. Nedostatak konvencionalne magnetske rezonancije je nemogućnost određivanja agresivnosti tumora i analize tumorskog mikrookoliša. DWI i DCE metode sve se više primjenjuju za potrebe planiranja optimalne terapije i procjene njezine uspješnosti.

Abstract (english)

Cervical cancer is a malignant disease of the epithelial cells of the endocervix or exocervix. It is undeniably linked to Human Papilloma Virus infection. It is the fourth most common malignant disease in women in the world, while in Croatia it ranks 21st. Developed countries are witnessing a decline in the incidence of the cervical cancer, but the disease remains a burden on the health system of developing countries. Until 2018 the assessment of disease progression was based mostly on data obtained from clinical examination. However, magnetic resonance imaging, due to its ability to distinguish soft tissue, has been included in the staging protocol. Numerous studies have compared current practice of clinical staging and staging based on magnetic resonance imaging. It was found that magnetic resonance imaging provides more accurate data on disease progress on the basis of which it is possible to optimize further treatment plan. Magnetic resonance imaging is indicated when setting stage IB or higher, in case of preoperative work-up of patients candidates for sparing surgery, and is also used in protocol of monitoring the response to therapy and possible recurrence of the disease. On T2-weighted sequences, cervical cancer appears as a mass of medium to high signal intensity. The disadvantage of conventional magnetic resonance imaging is the inability to determine tumor aggressiveness and analyze the tumor microenvironment. DWI and DCE methods are being increasingly used for planning an optimal therapy and evaluating its success.

• Keywords: karcinom vrata maternice; magnetska rezonancija; DWI; DCE
• Keywords (english): cervical cancer; magnetic resonance imaging; DWI; DCE
• Language: croatian
• URN:NBN: urn:nbn:hr:105:467429
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-03-17 10:37:12