Seventeen patients with locally advanced cancer (LACC) undergoing brachytherapy (BRT) after external beam radiotherapy (EBRT) were recruited. MR images were analysed, considering volume and ADC as variables during treatment. A significant decrease in volume during treatment was observed, more pronounced after EBRT than after BRT, which serves as a boost. Conversely, the ADC value appeared to increase somehow linearly with treatment, with mean initial values of 0.71 ± 0.06 × 10−3 mm2/s and final values of 1,29 ± 0.50 × 10−3 mm2/s. In relapsing patients, the difference between initial and post-treatment ADC values seemed significantly smaller compared to responder patients.

MRI is fundamental in the diagnosis and staging of the prostate cancer. EPE score is a valid strategy to detect extra-capsular extension of the tumor. Our classification, combining EPE score together with “capsular enhancement sign” enhances the clinical accuracy in reporting the locoregional staging.

ESUR Scientific Poster

In 2018 FIGO revised the staging system of cervical carcinoma (cc) emphasizing the lymph node involvement (LNI), configured in stage IIIC. Recently Node-Rads has been introduced to provide a standardized assessment system for LNI based on 5 point scale. In our study, we have hypothesized that the Node-RADS score could accurately predict LNI in patients with cc, by correlating the results with histological data. The secondary objective focuses on assessing the applicability of the score among readers. From 2014 to 2023, 140 patients were taken care of our Department and underwent clinical examination, multiple biopsies, neoadjuvant chemotherapy and lymphadenectomy surgery. All patients performed MRI prior to treatment. Two readers, blinded to histopathological data, retrospectively classified lymph nodes (LN) according to the MRI node-RADS scoring system. The assigned scored was compared to the actual involvement of neoplasia on a statistical basis. Secondly three different readers have separately assigned a score for all LN detected by MRI. Overall data from 65 patients were collected. Retrospectively, the analysis was performed on the MRI images, by considering the main LN stations and dividing them into right and left station by assigning a NODE-RADS score for each. 397 lymph nodes were classified as NODE-RADS 1 , 42 as NODE-RADS 2, 34 as NODE RADS 3 , 25 as NODE-RADS 4 and 14 as NODE-RADS 5. By considering a Node-RADS 4–5 positive and a Node-RADS 1–2 negative, the PPV was 100% and the NPV was 80%. A crucial point was the NODE RADS 3 subgroup. Specifically of 34 LN classified as NODE-RADS 3,24 were subclassified as low risk and 10 were overclassified as high-risk, comparing with the anatomical-pathological data. Excellent inter-reader agreement was found. Our study demonstrates the prognostic potential of NODE-RADS MRI score for radiological standardization of LN in cc.

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The Prostate Imaging Quality Score (PI-QUAL): is inter-reader agreement a factor to consider? Introduction: In terms of diagnosis, Magnetic Resonance Imaging (MRI) stands out for its increasingly evident role in the detection and risk stratification of PCa. Optimal image acquisition is crucial to mantain high confidence on the technique and image quality check is currently considered mandatory. PI-QUAL has emerged as a tool for this but still lacks validation. Aims: The main purpose of this study is to assess the level of agreement between three raters with different levels of experience. Methods: We identified sixty-four patients with PCa in the same University Hospital in 2019. Therefore, three readers applied PI-QUAL Score independently. Results: We observed moderate interrater reliability between three readers of different experience assigning the PI-QUAL category to prostate MRI examinations and slight agreement for most qualitative/anatomical item. Conclusions: This scoring system can be used within commonly accepted levels of agreement, specially if a simplified 3-point scale version is used. However, it is anticipated that the scoring system will need to undergo further refinements. Keywords: Inter-Reader Agreement; Quality standards; Multiparametric Magnetic Resonance Imaging; Prostatic Cancer.