Diagnostic Accuracy of Magnetic Resonance Imaging for International Federation of Gynecology and Obstetrics 2018 IB to IIB Cervical Cancer Staging: Comparison Among Magnetic Resonance Sequences and Pathologies

Abstract

Objective: This study aimed to investigate the most accurate magnetic resonance (MR) sequence for tumor detection, maximal tumor diameter, and parametrial invasion compared with histopathologic diagnoses.Methods: Fifty-one patients with International Federation of Gynecology and Obstetrics 2018 IB1 to IIB cervical cancer underwent preoperative MR imaging and surgical resection. Two radiologists independently evaluated the tumor detection, parametrial invasion, and tumor size in each of T2-weighted image, diffusion-weighted image, and contrast-enhanced T1-weighted image. Results obtained for squamous cell carcinoma (SCC) and adenocarcinoma were also compared. Results:Neither the tumor detection rate nor parametrial invasion was found to be significantly different among sequences. Tumor size assessment using MR imaging with pathology showed good correlation: r = 0.63-0.72. The adenocarcinoma size tended to be more underestimated than SCC in comparison with the pathologic specimen.Conclusions: Cervical cancer staging by MR images showed no significant difference among T2-weighted image, diffusion-weighted image, and contrast-enhanced T1-weighted image. Adenocarcinoma was prone to be measured as smaller than the pathologic specimen compared with SCC.

Systematic Review—Role of MRI in Cervical Cancer Staging

“…Ran et al’s [ 22 ] MRI findings were evaluated by a radiologist with 7 years’ experience in pelvic MRI diagnosis and a senior radiologist with 20 years’ experience in pelvic MRI diagnosis. For Matsumoto et al [ 23 ], all the MR examinations were interpreted independently by 2 board-certified radiologists with 24 years and 11 years of experience in gynecologic cancer imaging. For Rockall et al [ 25 ], all the imaging scans were read by one local and two central radiologists.…”

“…Five articles reported on parametrial invasion ( Table 1 ) [ 6 , 21 , 22 , 23 , 24 ]. Four of these articles used parametrial invasion as a measurable outcome, and for the reference standard, three of these articles used histopathology and one used clinical examination.…”

The Utility of Contrast-Enhanced Magnetic Resonance Imaging in Uterine Cervical Cancer: A Systematic Review

“…We found 21 studies that investigated the use of CE-MRI in staging. Most studies compared the diagnostic accuracy of contrast and non-contrast sequences, using different types of sequences such as single-phase post-contrast acquisition [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ], dynamic contrast enhancement [ 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ], and perfusion sequences [ 39 , 40 ]. These studies reported different results.…”

“…These studies reported different results. Some showed a decrease in diagnostic accuracy with the use of contrast agents [ 19 , 20 , 25 , 26 , 28 , 32 , 33 ] or did not reach statistical significance [ 10 , 23 , 24 , 27 , 31 , 36 ]. In contrast, others showed a slight improvement in diagnostic accuracy [ 15 , 17 , 21 , 22 , 29 , 30 , 34 , 37 , 39 , 40 ].…”

Predicting the recurrence of usual-type cervical adenocarcinoma using a nomogram based on clinical and pathological factors: a retrospective observational study

“…Despite standardized initial therapy, 10–50% of patients with cervical cancer experience recurrence ( 3 , 4 ), and the long-term survival rate for patients with recurrence is only 10–20% ( 5 ). Tumor recurrence is the leading cause of death in patients with cervical cancer.…”