CERVICAL-CARCINOMA - COMPUTED-TOMOGRAPHY AND MAGNETIC-RESONANCE-IMAGING FOR PREOPERATIVE STAGING

Objective: To assess the accuracy of computed tomography (CT) and magn etic resonance imaging (MRI) in the evaluation of invasive cervical ca ncer. Methods: Seventy-nine women with untreated cervical cancer under went pre-treatment MRI (n = 71) and/or CT (n = 37) within 4 weeks of s urgical evaluation. Twenty-nine women had both MRI and CT. Images were evaluated for tumor detection, size, stromal invasion, local extensio n, and nodal metastases. Results: Tumor size was evaluated accurately by MRI, with a correlation coefficient of 0.93. Magnetic resonance est imates of tumor size were within 0.5 cm of the surgical sample in 64 o f 69 women (93%). Magnetic resonance was 88% accurate evaluating the p resence of stromal invasion and 78% accurate for depth of stromal inva sion. Computed tomography could not evaluate tumor size or stromal inv asion because it could not distinguish cancer from the surrounding nor mal cervical tissue. In evaluating stage of disease, MRI had an accura cy of 90%, compared with 65% for CT (P < .005). Magnetic resonance ima ging was more accurate than CT (94 versus 76%, P < .005) in assessing parametrial invasion. Both modalities were comparable in evaluating ly mph node metastases (86% each). In determining operative candidates (s tage I and minimal IIA), MRI was 94% accurate, compared with 76% for C T CP <.005). Conclusion: Compared with CT, MRI offered significantly i mproved evaluation of tumor size, stromal invasion, and local and regi onal extent of disease in pre-treatment imaging for cervical cancer.