IRRADIATION OF THE CERVIX UTERI - VALUE OF UNENHANCED AND CONTRAST-ENHANCED MR-IMAGING

PURPOSE: To analyze the value of magnetic resonance (MR) imaging after radiation therapy for cancer of the cervix. MATERIALS AND METHODS: Ei ghty-nine MR images were retrospectively studied in 69 patients aged 4 6.3 years +/- 11.5. MR findings of tumor recurrence and irradiation ch anges were correlated with time after radiation therapy; paracentral r adiation dose (dose to point A); and in patients with pretreatment ima ges, primary tumor size and stage. RESULTS: Overall accuracy of MR in diagnosis of tumor recurrence was 78% (positive predictive value, 65%; negative predictive value, 97%). In MR examinations less than 6 month s after the beginning of radiation therapy, accuracy (69%) and specifi city (46%) were significantly lower than in examinations more than 6 m onths later (88%, P = .0032; 81%, P = .0166, respectively). Comparison of pre- and posttreatment MR findings and knowledge of stage or initi al tumor size did not affect MR results. CONCLUSION: Overall, diagnosi s was best with unenhanced T2-weighted images, but in patients with ad nexal or pelvic sidewall recurrence and in patients with treatment com plications (eg, fistula formation), contrast enhancement did help.