The Usefulness of MRI in The Assessment of Locoregional Invasion of Cervical Cancer

Min, Y S; Kang, J S

Abstract

Accurate staging prior to surgery is essential in the management of cervical carcinoma. To evaluate the usefulness of magnetic resonance imaging [MRI] in the clinical staging of cervical carcinoma, from March 1989 to December 1996, at Korea University Hospital, the accuracy of clinical staging and MRI staging were determined retrospectively in 87 consecutive patients in whom the extent of disease was surgically confirmed. The results were as follows ; 1. Clinical staging had an overall accuracy of 49.9% in the assessment of histopathologic extent of the cervical carcinoma. 2. Staging of cervical carcinoma solely based upon MRI revealed an accuracy rate of 57.5%. It had an accuracy of 100% for Ia and 45.2% for Ib, and this difference was statistically significant. 3. The accuracy rate of the radiologic assessment of invasion into vagina was 92%, 89% for parametrium, and 94% for lymph node, and its specificity in the evaluation of invasion into vagina was 94%, 95% for parametrium, and 94% for lymph node metastasis. We concluded that the MRI was proved to be a highly accurate and specific modality in the assessment of the locoregional extent of the cancer, but it had a limit in the assessing the depth of cervical stromal invasion. The clinical staging of cervical carcinoma using MRI would be more accurate in the way of refinement of the diagnostic tools and more judicious assessment of the extent of the diseaes.