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Cervical and uterine cancers
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Rosemarie Forstner, Andrea Rockall
Although contrast-enhanced T1-weighted imaging (T1WI) is not part of the routine protocol for cervical cancer staging, it may assist in depiction of lesions not seen at T2WI. Here, dynamic contrast-enhanced (DCE) imaging is applied, as it offers the advantage of visualization of contrast media passage and also allows a semiquantitative analysis (52,53).
Are we better off using multiple endometriosis classifications in imaging and surgery than settle for one universal less than perfect protocol? Review of staging systems in ultrasound, magnetic resonance and surgery
Published in Journal of Obstetrics and Gynaecology, 2022
Tereza Indrielle-Kelly, Michael Fanta, Filip Frühauf, Andrea Burgetová, David Cibula, Daniela Fischerová
Enzian classification derived its name from a hotel name where this system was developed during a local expert meeting by Keckstein et al. (2003) and was updated in 2012. Its main aim was to describe deep infiltrating lesions so the pelvis was divided into three zones with the cervix in the centre: A, rectovaginal space and vagina; B, uterosacral ligaments, pelvic sidewall, ureters; C, rectum. Other sites of disease are defined by prefix F (from fremd, which means foreign, strange in German) and sign posted by first letter: FI intestinal, FU ureteral, FB bladder, FA adenomyosis, FO other (lungs etc). By the anatomical distribution of the A, B and C zones, this staging system resembles cervical cancer staging and similarly to TNM the description follows ABCF site order. For example, a patient with adenomyosis, 0.5 cm vaginal nodule and 3.2 cm sigmoid lesion would be classed as Enzian: A1 B0 C3 FA. As a surgical system, it can be used for intraoperative surgical staging but it also takes into consideration findings from other diagnostic methods in case of extrapelvic spread. Moreover, the application of the Enzian score in MRI reporting has been shown to have a good correlation with laparoscopic findings, making it suitable tool for preoperative evaluation (Di Paola et al. 2015).