The correlation of preoperative CT, MR imaging, and clinical staging (FIGO) with histopathology findings in primary cervical carcinoma

Abstract

The aim of this study was to compare the preoperative findings of abdominal/pelvic CT and MRI with the preoperative clinical International Federation of Obstetrics and Gynecology (FIGO) staging and postoperative pathology report in patients with primary cancer of the cervix. Thirty-six patients with surgical-pathological proven primary cancer of the cervix were retrospectively studied for preoperative staging by clinical examination, CT, and MR imaging. Studied parameters for preoperative staging were the presence of tumor, tumor extension into the parametrial tissue, pelvic wall, adjacent organs, and lymph nodes. The CT was performed in 32 patients and MRI (T1- and T2-weighted images) in 29 patients. The CT and MR staging were based on the FIGO staging system. Results were compared with histological findings. The group is consisted of stage 0 (in situ):1, Ia:1, Ib:8, IIa:2, IIb:12, IIIa:4, IVa:6, and IVb:2 patients. The overall accuracy of staging for clinical examination, CT, and MRI was 47, 53, and 86%, respectively. The MRI incorrectly staged 2 patients and did not visualize only two tumors; one was an in situ (stage-0) and one stage-Ia (microscopic) disease. The MRI is more accurate than CT and they are both superior to clinical examination in evaluating the locoregional extension and preoperative staging of primary cancer of the cervix.

Multimodal endocavitary ultrasound versus MRI and clinical findings in pre- and post-treatment advanced cervical cancer. Preliminary report.

“…Published data focused on staging cervical cancer by comparing MRI with clinical examination described an accuracy of 47% for clinical examination and 86% for MRI in the study of Ozsarlak et al [21] on 29 patients, and 61.3% for clinical examination and 89.3% for MRI as reported by Dhoot et al [22].…”

Staging of uterine cervical cancer with MRI: guidelines of the European Society of Urogenital Radiology

“…Uterine cervical cancer is the third most common gynaecological malignancy after endometrial and ovarian cancers [1]. Nearly 80% of cervical cancer occurs in the developing countries and most patients are diagnosed with the disease at an advanced stage, thus not suitable for surgical staging.…”

Advanced Imaging Applications for Locally Advanced Cervical Cancer

“…For primary tumor assessment, MRI showed higher ability than CT to visualize the tumor, especially for endocervical lesion . For early parametrial assessment, MRI shows higher sensitivity with similar specificity compared to CT (Bipat et al, 2003;Ozsarlak et al, 2003;Hricak et al, 2007;Balleyguier et al, 2011;Bell & Pannu, 2011) (Figure 1). However, MRI is equal to CT for detecting the gross parametrial invasion in the locally advanced disease.…”