Research project Advanced diagnostic imaging can be used in gynecological cancer treatment planning and may contain additional prognostic information. In the PRODIGYN study patients with cervical, endometrial, and epithelial ovarian cancer will undergo extended diagnostic imaging and histopathological analyses of tumour tissue, in order to assess the diagnostic and prognostic added value, aiming to improve diagnostics and treatment of patients with gynecological cancer.
Diagnostic imaging with magnetic resonance tomography (MR), computed tomography (CT) and positron emission tomography with combined CT (PET/CT) can be used in diagnostic work-up and follow-up of gynecological cancer. PET combined with MR (PET/MR) may further improve diagnostics. Several studies support that PET data also may contain prognostic information. This study aims to evaluate both the diagnostic and prognostic added value of 18F-fluoro-deoxy-glucose (FDG)-PET/CT and FDG-PET/MR in the three largest groups of gynecological cancer: cervical, endometrial, and epithelial ovarian cancer.
Diagnostic imaging with magnetic resonance tomography (MR), computed tomography (CT) and positron emission tomography with combined CT (PET/CT) can be used in diagnostic work-up and follow-up of cervical cancer, endometrial cancer, and epithelial ovarian cancer. PET combined with MR (PET/MR) may further improve diagnostics. Several studies support that PET data also may contain prognostic information.
The two main aims are, for cervical cancer, endometrial cancer, and epithelial ovarian cancer, to:
1) Retrospectively validate the added value of radiological staging to clinical staging. Radiological stage (rFIGO) will be compared to clinical stage (cFIGO), with histopathological stage (pFIGO) as reference. The agreement between rFIGO and cFIGO will be evaluated, and compared to pFIGO, if available. The added value of rFIGO will be described in metastasis assessment and change of clinical management. Incidence and pattern of radiotherapy side effects will be outlined.
2) Prospectively identify prognostic biomarkers with FDG-PET/CT and FDG-PET/MRI, and prove the benefits of PET/MRI. FDG-PET/CT and FDG-PET/MRI parameters will be studied at baseline and at follow-up 3 months after therapy and compared to progression-free survival up to five years.
Secondary aims are to:
1) Improve non-invasive lymph node staging in endometrial cancer, by evaluation of imaging characteristics in resected sentinel lymph nodes, with histopathology as reference.
2) Develop a machine learning-based model for characterization of ovarian lesions, classified according to O-RADS MRI, for future use as a diagnostic decision support tool.
