Role of Mri in Staging of Carcinoma Cervix

Abstract

Cervical carcinoma continues to be staged according to the clinical FIGO classification system which is not accurate. In our study, we determined the diagnostic accuracy of MRI in staging carcinoma cervix with same parameters as FIGO staging. AIMS In our study, we determined the diagnostic accuracy of MRI in staging carcinoma cervix, adjoining organ infiltration and delineating stage IIA and below from rest of the stages in carcinoma cervix. SETTINGS Study was done in the Department of Radiodiagnosis, in a tertiary care government hospital on 70 female patients diagnosed with carcinoma cervix. DESIGN Hospital based observational study. MATERIALS AND METHODS MRI staging was correlated with surgico-pathological findings when patient underwent surgery. MRI staging was compared to the non-pathological staging when patient underwent radiotherapy or neoadjuvant chemotherapy. STATISTICAL ANALYSIS Univariate and bivariate frequency tables are generated. Sensitivity, specificity and accuracy of MRI in staging of carcinoma cervix are calculated. Interclass correlation is done with Pearson's correlation coefficient , p value ≤ 0.05 was considered statistically significant. RESULTS MRI has a sensitivity, specificity, PPV, NPV and accuracy of 88.7%, 87.5%, 98.2%, 50% and 88.6% respectively [with interclass correlation coefficient r=0.982, p<0.01 95% CI (0.972-0.989)] in staging of carcinoma cervix. CONCLUSIONS MRI in staging carcinoma cervix is preferred to clinical FIGO staging for deciding on the treatment modality. However, MRI is not a good modality in detecting carcinoma in situ [stage 0] and stage I of carcinoma cervix.