Mária Gődény

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Kristen J Gremillion

Ohio State University

Ahmad A Hanandeh

Yarmouk University

Otis Crandell

Memorial University of Newfoundland

Armando Marques-Guedes

UNL - New University of Lisbon

Ramiro Barberena

National Scientific and Technical Research Council

Michael Dietler

University of Chicago

Santiago Ginnobili

Universidad de Buenos Aires

Leonardo García Sanjuán

Universidad de Sevilla

Christian Jeunesse

Université de Strasbourg

Onur Toka

Hacettepe University

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Papers by Mária Gődény

Multiparametrikus MR vizsgálat prognosztikai és prediktív faktorokat meghatározó szerepe fej-nyaki tumoroknál, valamint a kismedence főbb daganat csoportjaiban

Dynamic Contrast-Enhanced MRI Parameters as Biomarkers in Assessing Head and Neck Lesions After Chemoradiotherapy Using a Wide-Bore 3 Tesla Scanner

Pathology & Oncology Research, 2015

Pilot studies have shown promising results in characterizing head and neck tumors (HNT) using dyn... more Pilot studies have shown promising results in characterizing head and neck tumors (HNT) using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), differentiating between malignant and benign lesions and evaluating changes in response to chemoradiotherapy (CRT). Our aim was to find DCE-MRI parameters, biomarkers in evaluating the post-CRT status. Two hundred and five patients with head and neck lesions were examined with DCE-MRI sequences. The time intensity curves (TIC) were extracted and processed to acquire time-to-peak (TTP), relative maximum enhancement (RME), relative wash-out (RWO), and two new parameters attack and decay. These parameters were analyzed using univariate tests in SPSS (Statistical Package for the Social Sciences, version 17, SPSS Inc. Chicago, USA) to identify parameters that could be used to infer tumor malignancy and post-CRT changes. Multiple parameters of curve characteristics were significantly different between malignant tumors after CRT (MACRT) and changes caused by CRT. The best-performing biomarkers were the attack and the decay. We also found multiple significant (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05) parameters for both the benign and malignant status as well as pre- and post-CRT status. Our large cohort of data supports the increasing role of DCE-MRI in HNT differentiation, particularly for the assessment of post-CRT status along with accurate morphological imaging.

Impact of 3T multiparametric MRI and FDG-PET-CT in the evaluation of occult primary cancer with cervical node metastasis

Cancer imaging : the official publication of the International Cancer Imaging Society, Jan 4, 2016

This study aimed to determine the ability of multimodal evaluation with multiparametric 3T-MRI (M... more This study aimed to determine the ability of multimodal evaluation with multiparametric 3T-MRI (MPMRI) and positron emission tomography - computed tomography (PET/CT) to detect cancer of unknown primary origin (CUP) with neck lymph node (LN) metastasis. The study group comprised 38 retrospectively analysed consecutive patients with LN metastasis in the head and neck (HN) region without known primary tumours (PTs). Statistical values of 3T-MRI and of FDG-PET/CT scans were evaluated. Of the 38 CUPs, conventional native T1-, T2-weighted and STIR sequences detected 6 PTs. Native sequences plus diffusion-weighted imaging (DWI) found 14-, and with fat suppression contrast-enhanced T1-weighted measurement as well as with the complex MPMRI found 15 primaries and with PET/CT 17 CUPs could be evaluated, respectively. The detection rates were 15.8, 36.8, 39.5, 39.5 and 44.7 % for conventional native MRI, native plus DWI, native with contrast-enhanced MRI (CE-MRI), for MPMRI, and for PET/CT, re...

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A fej-nyak régió MR-diagnosztikai lehetôségei

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A képalkotó vizsgálómódszerek alkalmazása daganatok esetében "Javaslat a képalkotók alkalmazásához

Magyar Onkológia

A képalkotó technika rohamos fejlôdésével egyre pontosabbá váltak a daganat kimutatásának módszer... more A képalkotó technika rohamos fejlôdésével egyre pontosabbá váltak a daganat kimutatásának módszerei, és azok a lehetôségek, melyekkel meghatározhatjuk egy daganat kiterjedését, változását. Számos lehetôségbôl kell kiválasztani az optimális vizsgálati módszert, és meghatározni a betegség követését, a vizsgálatok idôzítését. Azonos elvek és feltételek alapján szervezett és mûködô onko-radiodiagnosztika szükséges ahhoz, hogy a leghatékonyabb terápiát szolgáló képalkotói diagnosztikát alakíthassuk ki. Olyan protokollt kell választanunk, mely standard technikát képvisel, a képalkotói stratégia fölállításakor a rutinszerûen alkalmazott sémák mellett figyelembe veszi az egyéni különbözôségeket, egyedi igényeket az individuális kezelési és diagnosztikus formák kialakításához, és megfelelô stratégiával rendelkezik a klinikai kutatások számára is. Onkológiai bizottság (multidiszciplináris team) szakmai irányítása szükséges, amely meghatározza az alkalmazandó terápiát és a diagnosztikus módszereket. A választott terápia vezeti a továbbiakban a diagnosztikai módszerek alkalmazását, idôzítését. A terápia által ütemezett diagnosztika vizsgálja a kezelés hatékonyságát. A követéses vizsgálatok jelentôsége azonos a diagnózist felállító és stádiumot meghatározó tevékenységével. A választás és a döntés komplex, gépi lehetôséghez kötött, speciális szaktudástól függ, a klinikus és a radiológus szoros együttmûködésén alapszik. A radiológus szerepe a multidiszciplináris teamben az, hogy a team által meghatározott stratégiát adaptálja a képalkotói módszerekre. A daganatos betegek nagy értékû vizsgálatait olyan szervezettségben, diagnosztikus és terápiás egységekben kell végezni, ahol együtt érvényesülnek a betegek érdekeit képviselô szakmai szabályok és az egészségügy gazdaságosabb mûködését szolgáló elvek. Magyar Onkológia, 48:167-190, 2004 Rapid development of imaging techniques provided much more precise methodology of diagnosis, staging and dynamics of cancer. Nowadays the onco-radiodiagnostic units are able to select the optimal imaging technique based on established international protocols. These protocols provide the basis of cancer diagnosis, therapy control and clinical research. The onco-radiodiagnostic unit is essential part of the oncoteam managing the cancer patients. Follow-up protocols are now equally important compared to those of the diagnosis and staging, requiring a continuous interaction between radiologists and physicians. The comprehensive cancer centers with all the necessary imaging techniques are the optimal organizations where professional and economic priorities both can be considered for the benefit of cancer patients. Gödény M, Kásler M. Diagnostic imaging of cancer. Hungarian Oncology 48: 2004 Az onko-radiodiagnosztika a radiológián belül speciális terület, egyre nagyobb a társadalmi jelentôsége, nemcsak a daganat kimutatásában és a stádium meghatározásában, hanem a daganatterápia hatékonyságának felmérésében és a betegség követésében is. A diagnosztika feladata, hogy kövesse a betegséget, minél korábban kimutassa a recidív daganatot és újabb, pontos stádiumot határozzon meg.

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[Role of CT and MR examinations in the assessment of nasopharyngeal tumors]

Orvosi Hetilap

[Diagnostic imaging of cancer]

Magyar Onkológia

Rapid development of imaging techniques provided much more precise methodology of diagnosis, stag... more Rapid development of imaging techniques provided much more precise methodology of diagnosis, staging and dynamics of cancer. Nowadays the onco-radiodiagnostic units are able to select the optimal imaging technique based on established international protocols. These protocols provide the basis of cancer diagnosis, therapy control and clinical research. The onco-radiodiagnostic unit is essential part of the oncoteam managing the cancer patients. Follow-up protocols are now equally important compared to those of the diagnosis and staging, requiring a continuous interaction between radiologists and physicians. The comprehensive cancer centers with all the necessary imaging techniques are the optimal organizations where professional and economic priorities both can be considered for the benefit of cancer patients.

[Technical novelties, latest diagnostic options in the MRI and CT diagnostics of colorectal cancer]

Magyar onkologia, Jan 4, 2015

Diagnostic and therapeutic options of colorectal cancer (CRC) have changed over the past decade. ... more Diagnostic and therapeutic options of colorectal cancer (CRC) have changed over the past decade. Imaging plays a major role, thus the use of scanning methods is recommended by guidelines. Accurate staging, evaluation of treatment efficacy and identification of residual and recurrent tumors are required for the modern management of colorectal cancer. If adequate technical background is provided, magnetic resonance imaging (MRI) gives the information upon which therapeutic options may be determined. High-resolution MRI scans can be interpreted as maps providing functional and molecular information. Diffusion-weighted MRI (DW-MRI) has shown promising results regarding the determination of tumor volume and evaluation of treatment efficacy. Perfusion dynamic contrast-enhanced MRI (P-DCE-MRI) is the subject of research in the early assessment of treatment efficacy. Magnetic resonance spectroscopic imaging (MRSI) is a procedure utilizing biochemical analysis. Its application in CRC is unde...

[New opportunities, MRI biomarkers in the evaluation of gynaecological cancer]

Magyar onkologia, Jan 4, 2015

The determination and classification of gynaecological tumour stage which is based on clinical an... more The determination and classification of gynaecological tumour stage which is based on clinical and pathological examinations became more precise due to the development of imaging techniques. Recently new MRI methods are being introduced which serve functional, tissue-specific, molecular information; beyond the excellent anatomical and contrast resolution with the aid of high resolution morphological measurements as well as quantification can also be performed. Diffusion-weighted MRI (DW-MRI) is based on the mobility of water molecules and provides information about the cell density of a given tissue and the integrity of cell membranes. Quantification can also be performed using an apparent diffusion coefficient (ADC). DW-MRI is a useful tool in determining myometrium invasion in endometrium carcinomas especially if a tumour has the same signal intensity as the makromomyometrium on the T2-weighted images and the use of contrast agents are contraindicated. The extra-uterine tumour inv...

Abstract 242: A novel approach to select cancer initiating cells by targeting unique sialilated glycosphingolipids and CD20 in patients with metastatic melanomas

Cancer Research, 2013

Prognostic factors in advanced pharyngeal and oral cavity cancer; significance of multimodality imaging in terms of 7th edition of TNM

Cancer imaging : the official publication of the International Cancer Imaging Society, 2014

As with most cancers the prognosis in pharyngeal and oral cavity cancer largely depends on tumour... more As with most cancers the prognosis in pharyngeal and oral cavity cancer largely depends on tumour stage. Physical examination, including endoscopy should be combined with technical radiologic imaging to record the precise extent of tumour. The TNM staging system of the head and neck region is, in fact, an anatomic staging system that describes the anatomic extent of the primary tumour as well as the involvement of regional lymph nodes and distant metastases. Modifications in the TNM staging system should consider not only the expert opinions and published reports in the literature but the technical advances in technology for improved assessment of tumour extent and the shifting paradigms in therapeutic strategies. "T" stage of the tumour is defined by its size, the depth of the invasion and the involvement of vital structures. In the 7th edition of TNM classification, for stage T4 tumors (larger than 4 cm), subcategories a and b were introduced to indicate the involvement ...

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Successful Treatment of Solitary Bone Metastasis of Non-Small Cell Lung Cancer with Bevacizumab and Hyperthermia

Pathology & Oncology Research, 2012

Non-small cell lung cancer (NSCLC) represents 85 % of all malignant lung cancers. In metastatic d... more Non-small cell lung cancer (NSCLC) represents 85 % of all malignant lung cancers. In metastatic disease the principle goal of palliative therapy is to prolong survival with least toxicity and best patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; quality of life. Bevacizumab (BEV) has been approved as first line treatment in combination with platinum based chemotherapy and maintenance therapy in NSCLC. BEV can be added safely to several chemotherapeutic agents, however there is no data on coadministration with thermotherapy. Even in localized disease no robust evidence exists about the beneficial effect of loco-regional thermotherapy on overall survival, but it might be used successfully in symptom palliation. In this article a successful co-administration of BEV and hyperthermia is reported in a patient with monolocalized bone metastasis from previously operated NSCLC. This case suggests that electrohyperthermia can probably be incorporated in palliative therapy added not only to radiotherapy or chemotherapy but also to anti-angiogenic BEV treatment.

Unusual Abdominal and Pelvic Tumors: CASE 3. RESECTION OF ORIGINALLY INOPERABLE LIVER METASTASES OF GASTROINTESTINAL STROMAL TUMOR AFTER IMATINIB MESYLATE THERAPY

Journal of Clinical Oncology, 2003

A 52-year-old woman with a medical history significant for a benign brain tumor presented with a ... more A 52-year-old woman with a medical history significant for a benign brain tumor presented with a several-year history of pain in the anal area and vagina. The pain was associated with a progressively increasing mass in the rectovaginal area. She denied hematochexia, vaginal bleeding, fecal or urinary incontinence, and weight loss. She admitted to pain while sitting and with ambulation. Her CBC and biochemistry were normal, and her physical examination was unremarkable except for a definite visible and palpable fullness in the left buttock. An infused spiral computed tomography scan revealed a large irregular left pararectal mass measuring 15 ϫ 7 cm . The mass was indistinguishable from the left lateral rectal wall. The lesion was displacing the rectum, bladder, and uterus toward the right side of the pelvis. A magnetic resonance imaging scan of the pelvis could not be obtained secondary to surgical clips present in the brain. An endorectal ultrasound was obtained and showed asymmetry and marked thinning of the left internal sphincter, without tumor involvement of the sphincters. A core biopsy of the mass revealed a soft tissue proliferation of stellate, and spindled cells with hyperchromatic small nuclei and small nucleoli . A prominent vascular pattern composed of dilated capillaries, venules, and arteries was present. Immunohistochemical staining show the proliferative cells to be positive for vimentin, negative for S100 and actin, and weakly positive for estrogen and progesterone receptors. The biopsy was consistent with an aggressive angiomyxoma. After the work-up was completed, it was believed that to achieve a complete resection, extensive surgery would be required. The need for an abdominoperineal resection was likely, as well as the potential need to remove the uterus, left ovary, and a portion of the bladder. The close proximity with the iliac vessels was also a concern, and the risk for massive blood loss and blood transfusion was discussed. An aggressive angiomyxoma of the pelvis is a rare, locally infiltrative lesion usually treated with wide local excision. It was first described in 1983. 1 The "aggressive" adjective comes from their propensity to recur. Surgery has been the principal treatment to date. Since surgery would be life threatening and mutilating, a search for medical options was undertaken. There are case reports describing the potential responsiveness of this tumor to gonadotropin-releasing hormone agonist. 2 The patient was treated with 3.75 mg of leuprolide acetate (Lupron; Abbott Laboratories, Abbott Park, IL) by intramuscular injection monthly for 4 months, with marked symptomatic improvement. She was able to sit without discomfort, and she no longer experienced pain with ambulation. At follow-up, her physical examination failed to reveal a mass or fullness in the left buttock, apart from a small fullness present in the perineum, and a marked decrease in tumor size revealed in the follow-up computed tomography scan . At 4 months follow-up from her last gonadotropin-releasing hormone agonist treatment, the patient was doing well, her symptoms remain improved, and she had returned to her normal activities.

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Angiography-proven liver metastases explain low efficacy of lymph node dissections in medullary thyroid cancer patients

European Journal of Surgical Oncology (EJSO), 2005

Aim. To report the role of liver angiography in the staging of medullary thyroid cancer (MTC) pat... more

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Prediction of cervical infiltration in Stage II endometrial cancer by different preoperative evaluation techniques (D&C, US, CT, MRI)

European journal of gynaecological oncology

Our clinical practice for FIGO Stage II endometrial cancer consists of Wertheim's radical hys... more Our clinical practice for FIGO Stage II endometrial cancer consists of Wertheim's radical hysterectomy as first choice of treatment. The evaluation of patients is based on D&C. The accuracy of this preoperative staging method is examined here. Twenty-nine patients with endometrial cancer with suspected cervical involvement (FIGO Stage II) based on endocervical curettage underwent Wertheim's radical hysterectomy between January 1, 1989 and December 31, 2001 at the Gynaecological Department of the National Institute of Cancer, Budapest, Hungary. In all cases surgico-pathological staging was performed to examine the accuracy of preoperative D&C and to find out whether radical surgery was necessary in all patients and how the preoperative evaluation of patients should be improved. Out of 29 patients who underwent Wertheim's hysterectomy the pathological examination found primary cervical cancer in two patients. These two patients were eliminated from further evaluation. Out ...

[New opportunities in imaging of breast cancer]

Magyar onkologia, Jan 11, 2015

Complex tumor therapy development and new opportunities in surgery, which take into account both ... more Complex tumor therapy development and new opportunities in surgery, which take into account both oncological principles as well as esthetic aspects, have set the requirements far higher for diagnostic imaging of the breast and for radiologists. Despite these new opportunities, X-ray mammography remains the basic examination. However, part of the cancers is hidden on the mammogram, which is partly a consequence of the dense glandular tissue and may also be influenced by the histological type of cancer. Besides reducing radiation dose, digital X-ray mammography improves the examination sensitivity of the dense breast. State of the art digital examination methods, such as tomosynthesis and contrast-enhanced mammography, increase the accuracy of examination. Ultrasound mammography is the most important supplementary method of X-ray mammography. Among the new applications of ultrasound mammography, US elastography, which is based on different tissue elasticity, as well as automatic 3D ul...

[Salvage 125I brachytherapy of locally recurrent prostate cancer]

by Zsolt Lengyel, Péter Ágoston, and Mária Gődény

Magyar onkologia, 2014

The purpose of the study is to report a case of salvage low dose rate (LDR) prostate brachytherap... more The purpose of the study is to report a case of salvage low dose rate (LDR) prostate brachytherapy in a patient with locally recurrent prostate cancer, four years after his first treatment with combined external beam radiation therapy (EBRT) and high dose rate (HDR) brachytherapy. A 61-year-old man was treated with 1x10 Gy HDR brachytherapy and a total of 60 Gy EBRT for an organ confined intermediate risk carcinoma of the prostate in 2009. The patient's tumor had been in regression with the lowest PSA level of 0.09 ng/ml, till the end of 2013. After slow but continuous elevation, his PSA level had reached 1.46 ng/ml by February 2014. Pelvis MRI and whole body acetate PET/CT showed recurrent tumor in the dorsal-right region of the prostate. Bone scan was negative. After discussing the possible salvage treatment options with the patient, he chose LDR brachytherapy. In 2014, in spinal anesthesia 21 125I "seeds" were implanted with transrectal ultrasound guidance into the ...

[Histologic response after neoadjuvant therapy in rectal adenocarcinoma: own experience and review of the literature]

by Zs. Orosz and Mária Gődény

Orvosi hetilap, Jan 22, 2006

Neoadjuvant therapy has improved outcomes for patients with locally advanced rectal cancer. AIM A... more Neoadjuvant therapy has improved outcomes for patients with locally advanced rectal cancer. AIM AUTHORS: We studied the degree of histopathological regression after radiotherapy regimens commonly used in their clinical practice, and its effect on the pathology of by clinically founded T3-T4 rectal cancer. A total of 57 patients were investigated who underwent neoadjuvant radiotherapy or chemoradiotherapy--commonly used at our institute--for biopsy proven primary mid or lower third rectum adenocarcinoma between January and December 2004. The standard surgical treatment was anterior resection sec Dixon, Lloyd-Davies--and Hartmann's procedure, all with total mesorectal excision. The surgical specimens were examined by selected pathologists and a modified pathologic staging system the Rectal Cancer Regression Grade (RCRG) was used. (I) "good" response (n=12, 21%), (II) "median" response (n=25, 44%), (III) "poor" response (n=20, 35%). Significant tumor r...

Evaluation of the Accuracy of Preoperative MRI in Measuring Myometrial Infiltration in Endometrial Carcinoma

by Mária Gődény and Katalin Horváth

Pathology & Oncology Research, 2013

The aim of our study was to evaluate the diagnostic performance of magnetic resonance imaging (MR... more The aim of our study was to evaluate the diagnostic performance of magnetic resonance imaging (MRI) in the pretreatment evaluation of myometrium invasion in endometrial cancer. Our retrospective study concerns 89 patients with endometrial cancer, who had preoperative MR evaluation of myometrium invasion and we compared it with histological results. Considering histological type and grade, we had excluded patients with poor prognosis, and separately evaluated those cases where the depth of myometrium invasion is the main prognostic factor determining the choice treatment. Of the 89 cases MRI had accurately evaluated the depth of myometrial invasion in 75 patients. Based on data from all cases, we found the sensitivity of detection of deep myometrial infiltration by MRI (Sv) 71 %, specificity (Sp) 92 %, accuracy (Acc) 84 %, positive predictive value (PPV) 86 % and negative predictive value (NPV) 83 %. Excluding patients with poor prognosis according to histology and grade, these data were Sv 71 %, Sp 95 %, Acc 87 %, PPV 90 %, NPV 84 %. In conclusion, MRI is an efficient diagnostic tool in assessing myometrial infiltration, which is necessary for proper preoperative staging and therapy planning, including evaluation of the necessity of lymphadenectomy. Certain factors may interfere with evaluation of MRI results, thus hindering the precise determination of the level of myometrial infiltration.