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Original research article


Uterine cervical malignancy: diagnostic accuracy of MRI with histopathologic correlation

Mohammed A ShweelEnas A Abdel-GawadEhab Ali Abdel-GawadHosny S AbdelghanyAlshimaa M Abdel-RahmanEmad M Ibrahim
Departments of Radiology and Gynecology and Obstetrics, Minia University, Minia, Egypt
Date of Submission: 14-Apr-2012, Date of Acceptance: 23-May-2012, Date of Web Publication: 28-Jul-2012.
Corresponding Author:
Corresponding Author

Mohammed A. G. Shweel

Department of Radiology, Minia University, Kornish El Nile, Minia, Egypt.
E-mail: mohshweel@yahoo.com

Corresponding Author:
Corresponding Author

Mohammed A. G. Shweel

Department of Radiology, Minia University, Kornish El Nile, Minia, Egypt.
E-mail: mohshweel@yahoo.com

DOI: 10.4103/2156-7514.99175 Facebook Twitter Google Linkedin

ABSTRACT



Objective: Cervical cancer is the third most common malignancy in women worldwide. Accurate staging of the disease is crucial in planning the optimal treatment strategy. The aim of this study was to evaluate the role of magnetic resonance imaging (MRI) in the assessment of extension and staging of cervical malignancy in correlation with histopathologic examination.
Materials and Methods: Thirty females with untreated pathologically proven uterine cervical carcinoma were included in this prospective study. The patients were 40 - 65 years of age and their average age was 45 years. All patients were subjected to routine clinical staging workup and underwent MRI for preoperative staging. Preoperative MRI findings were reviewed and compared with the final pathological staging that is the Gold Standard of reference.
Results: Histopathologic examination established that of the 30 tumors, 22 (73.3%) were squamous cell carcinoma. According to the International Federation of Gynecology and Obstetrics (FIGO) staging criteria, 2/30 patients (6.6%) were stage IB, 12/30 (40.3%) were IIA, 8/30 were IIB (26.6%), and 8/30 (26.6%) were IVA. MRI had a sensitivity of 100% and specificity 85.7% in the detection of parametrial infiltration, and a sensitivity of 100% and specificity of 90% in the detection of vaginal infiltration. It was sensitive (100%) and specific (100%) in detecting tumor extension to the stroma, urinary bladder, and rectum. Pathological examination demonstrated stage IB cervical carcinoma in 2/30 patients (6.6%), stage IIA disease in 10/30 patients (33.3%), stage IIB in 6/30 patients (20%), and stage IV disease in 8/30 patients (26.6%). MRI features demonstrated stage IB in 2/30 patients (6.6%), stage IIA disease in 12/30 patients (40%), stage IIB in 8/30 patients (26.6%), and stage IV disease in 8/30 patients (26.6%). MRI staging of cervical carcinoma wa in concordance with histopathologic staging in stages IB and IVA and over-staging in IIA and IIB stages.
Conclusion: MRI is an optimal non-invasive modality for preoperative staging of uterine cervical malignancy, and crucial in subsequent more accurate treatment planning.
Keywords: Cervical Cancer, MRI, Histopathology, Tumor Staging

Cited in 5 Documents

  1. Wei Zhang, Jie Zhang, Jiaxin Yang, Huadan Xue, Dongyan Cao, Huifang Huang, Ming Wu, Quancai Cui, Jie Chen, Jinghe Lang and Keng Shen (2014) The Role of Magnetic Resonance Imaging in Pretreatment Evaluation of Early-Stage Cervical Cancer. Int J Gynecol Cancer 24(7):1292. doi: 10.1097/IGC.0000000000000169
  2. Sanne M. Schreuder, Rutger Lensing, Jaap Stoker and Shandra Bipat (2015) Monitoring treatment response in patients undergoing chemoradiotherapy for locally advanced uterine cervical cancer by additional diffusion-weighted imaging: A systematic review. J. Magn. Reson. Imaging 42(3):572. doi: 10.1002/jmri.24784
  3. Evelyn Dappa, Tania Elger, Annette Hasenburg, Christoph Düber, Marco J. Battista and Andreas M. Hötker (2017) The value of advanced MRI techniques in the assessment of cervical cancer: a review. Insights Imaging 8(5):471. doi: 10.1007/s13244-017-0567-0
  4. Sungmin Woo, Chong Hyun Suh, Sang Youn Kim, Jeong Yeon Cho and Seung Hyup Kim (2018) Magnetic resonance imaging for detection of parametrial invasion in cervical cancer: An updated systematic review and meta-analysis of the literature between 2012 and 2016. Eur Radiol 28(2):530. doi: 10.1007/s00330-017-4958-x
  5. Sree Harsha Tirumani, Alampady K.P. Shanbhogue and Srinivasa R. Prasad (2013) Current Concepts in the Diagnosis and Management of Endometrial and Cervical Carcinomas. Radiologic Clinics of North America 51(6):1087. doi: 10.1016/j.rcl.2013.07.003

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