IS MRI HELPFUL IN EVALUATING THE RESPONSE OF CERVICAL-CANCER TO NEOADJUVANT CHEMOTHERAPY

Background. To assess the potential role of magnetic resonance imaging (MRI) in evaluating the response of cervical tumor to neoadjuvant che motherapy. Methods. We studied 14 patients with locally advanced carci noma of the cervix. MRI was performed before and after each cycle. All patients underwent laparotomy four weeks after the last cycle. MR ima ges after chemotherapy were compared with surgical-pathologic findings . Results. Related to parametrial state after chemotherapy, surgical e xamination correlated with MRI in nine patients (nine true negative). In three cases parametrial invasion was overestimated (three false-pos itive) and in two it was underestimated, so that tumor resection was n ot possible once laparotomy was performed (two false-negative). MRI es timation of tumor size was confirmed at pathologic examination in only eight patients, whilst it was overestimated in the other four ones. C onclusions. These initial results suggest that MRI could not be as pre cise for cervix cancer staging and evaluation of response to chemother apy as has recently been postulated. This is especially important sinc e a false negative result may induce the surgeon to perform laparotomy in error in cases of unresectable tumors.