Radiography

Factors that affect engagement with physical activity for patients who have received radiotherapy as part of their gynaecological cancer treatment – A rapid review

Gynaecological cancer survivors can suffer from acute and chronic treatment related side effects, including those resulting from radiotherapy. This can lead to low levels of engagement in physical activity and reduced quality of life. This literature review explores these patients' engagement with physical activity and identifies the factors that impact upon it. Qualitative studies were identified via Medline, CINALH Complete and APA PsycInfo databases. A rapid review utilising a systematic approach was conducted. Studies incorporated were published in the last 10 years, peer reviewed, and included participants who were treated radically with radiotherapy. The search returned n = 68 papers. After analysis and utilising the PRISMA flow chart, six studies were included in the review. Key themes included side effects, education, social influences, practical and personal factors, as well as prior physical activity engagement. This literature review has identified side effects, education, social influences, practical and personal factors, as well as prior physical activity engagement as elements that interplay to shape individuals' attitudes and behaviours towards physical activity. Further studies are required to clarify the effect radiotherapy has on gynaecological cancer patients' engagement with physical activity. This review identified the need for health care professionals to receive an improved education surrounding information giving and advice for gynaecological cancer patients. Additionally, there is a lack of person-centred care provided, with a need for a tailored approach that recognizes survivors' unique preferences, physical limitations, and readiness to engage with physical activity, which are essential for promoting sustained participation.

Natural language processing evaluation of trends in cervical cancer incidence in radiology reports: A ten-year survey

Cervical cancer commonly associated with human papillomavirus (HPV) infection, remains the fourth most common cancer in women globally. This study aims to develop and evaluate a Natural Language Processing (NLP) system to identify and analyze cervical cancer incidence trends from 2013 to 2023 at our institution, focusing on age-specific variations and evaluating the possible impact of HPV vaccination. This retrospective cohort study, we analyzed unstructured radiology reports collected between 2013 and 2023, comprising 433,207 studies involving 250,181 women who underwent CT, MRI, or ultrasound scans of the abdominopelvic region. A rule-based NLP system was developed to extract references to cervical cancer from these reports and validated against a set of 200 manually annotated cases reviewed by an experienced radiologist. The NLP system demonstrated excellent performance, achieving an accuracy of over 99.5 %. This high reliability enabled its application in a large-scale population study. Results show that the women under 30 maintain a consistently low cervical cancer incidence, likely reflecting early HPV vaccination impact. The 30-40 cohorts declined until 2020, followed by a slight increase, while the 40-60 groups exhibited an overall downward trend with fluctuations, suggesting long-term vaccine effects. Incidence in patients over 60 also declined, though with greater variability, possibly due to other risk factors. The developed NLP system effectively identified cervical cancer cases from unstructured radiology reports, facilitating an accurate analysis of the impact of HPV vaccination on cervical cancer prevalence and imaging study requirements. This approach demonstrates the potential of AI and NLP tools in enhancing data accuracy and efficiency in medical epidemiology research. NLP-based approaches can significantly improve the collection and analysis of epidemiological data on cervical cancer, supporting the development of more targeted and personalized prevention strategies-particularly in populations with heterogeneous HPV vaccination coverage.

The sexuality of women with cervical cancer undergoing definitive radiotherapy in Ghana

The purpose of this study was to assess the sexuality of cervical cancer patients undergoing radiotherapy at a major cancer treatment center in Ghana. This is an area of interest as globally; cervical cancer kills approximately 342,000 people per annum with an estimated number of 604,000 new cases in 2020. Acknowledging the World Health Organization's definition of sexual health as a state of physical, mental and social well-being in relation to sexuality, this paper sheds light on how these dimensions affect the quality of life of cervical cancer patients. This was a longitudinal study, which assessed the impact of radiotherapy on the sexuality of both premenopausal and postmenopausal cervical cancer patients presenting for primary treatment with chemoradiation from April to July, 2021 at a major cancer treatment centre in Ghana. The Female Sexual Function Index and Body Image Scale questionnaires were respectively used to evaluate the sexual functions scores among the cervical cancer patients, and to assess the impact of the treatment on their body image. MATLAB software was used for data analysis. Most of the cervical cancer patients sampled were postmenopausal (57 %). About 79 % premenopausal and 96 % postmenopausal cervical cancer patients were sexually inactive during radiotherapy (day 15). Also, 48 % premenopausal and 24 % postmenopausal patients were very dissatisfied with their bodies at the onset of treatment. The frequency of orgasm in cervical cancer patients declined after treatment causing a deterioration in their sexual function. The patients' sexuality was influenced by age and menopausal status. The decreased sexual desire of the patients resulted in emotional distancing from their partners, which invariably induced changes in their partners' level of sexual interest. This study established significant differences between premenopausal and postmenopausal cervical cancer patients who were generally very dissatisfied with their sexual relationships with their partners on day 1 (p = 0.02) and on day 15 (p = 0.00) of treatment. The majority of patients who presented for treatment for cervical cancer in this study were postmenopausal. Their interest in sexual activity was more influenced by their menopausal status than their antineoplastic treatment. This study indicates that cervical cancer patients are more likely to develop sexual health problems which could substantially worsen over the course of their treatment and beyond. The study will contribute within the oncology team by assisting personnel in putting in place measures that will guide the treatment of cervical cancer patients and improve quality of care.

Diagnostic accuracy of intravoxel incoherent motion and diffusion kurtosis imaging in evaluating endometrial lesions - A systematic review

Proper clinical management requires accurate differentiation of benign and malignant endometrial lesions. Intravoxel Incoherent Motion (IVIM) and Diffusion Kurtosis Imaging (DKI) are non-invasive MRI methods that have emerged as key tools in this differentiation. This systematic review compares the diagnostic accuracy of IVIM and DKI in evaluating endometrial lesions. A systematic review of the literature was conducted using pertinent databases. Inclusion criteria were studies that compared IVIM and DKI for the differentiation of benign and malignant endometrial lesions and provided diagnostic performance statistics like area under the curve (AUC), specificity, and sensitivity. Meta-analysis was not performed in this review due to heterogeneity of the included studies, such as variation in b-values, magnetic field strengths of the MRI scanners, no standardized scanning parameters, and differences in Region of interest (ROI) selection as reported in the articles. The risk of bias was assessed using the QUADAS-2 tool. In total, 11 studies were included, which evaluated endometrial lesions. F, D, D∗, MD, and MK IVIM and DKI parameters had different diagnostic performances, with AUC ranging from 0.601 to 0.98. Sensitivity and specificity also differed widely between studies. The majority of studies used Echo Planar Imaging (EPI) sequences. Risk of bias assessment indicated moderate-to-high methodological quality. IVIM and DKI could offer promising non-invasive methods for distinguishing endometrial lesions. Yet, differences in methodology and heterogeneity of studies emphasize the necessity for further standardization. IVIM and DKI MRI can be used as non-invasive quantitative tools to provide insights about tissue microstructure and perfusion characteristics which help clinicians in characterization of endometrial cancers.

Does diffusion weighted imaging have a prognostic value in differentiating gynecological diseases?

Apparent diffusion coefficient (ADC) values are effective in the diagnosis of different gynecological lesions. A retrospective evaluation was made of 12 patients with uterine cervix carcinoma and 151 patients with uterine lesions, comprising endometrial cancer, endometrial polyps, carcinosarcoma, submucous myoma, adenomyosis, endometrial hyperplasia, gestational trophoblastic neoplasm (GTN), and leiomyomas. As a control group, 20 healthy volunteers with normal endometrium and normal cervix were also evaluated. In three series, one-shot, spin echo, echo planar, b = 1000 s/mm The mean ADC values of Group 1 (Endometrial carcinoma) were lower than those of all the other groups (P < 0.001) and the mean ADC value of group 6 (GTN) was higher than that all other groups (P < 0.001). A statistically significant difference was found between the groups in terms of the lesion-myometrium ADC ratios (P < 0.001). There are few studies in literature related to ADC measurements in GTN. The ADC values of GTN were found to be significantly higher than the other uterine lesions. These results will aid in the design of future studies and might be used to guide management of patients with GTN. Diffusion-weighted MRI seems to be a promising imaging technique in differentiating different uterine lesions.