Cervical carcinoma: Can dynamic contrast-enhanced MR imaging help predict tumor aggressiveness

PURPOSE: To determine whether fast dynamic contrast agent-enhanced magnetic resonance (MR) imaging can demonstrate tumor aggressive ness of cervical c arcinoma in patients who are eligible for surgical treatment. MATERIALS AND METHODS: Dynamic contrast-enhanced MR imaging of cervical car inoma was performed in 82 consecutive patients with stage I or IIA disease who were referred for radical hysterectomy. The maximum slope and amplitude of dynamic first-pass contrast enhancement were quantified. These paramete rs were correlated with histologic measures of tumor aggressiveness (tumor invasion depth, pelvic lymph node status). RESULTS: The analysis was based on tumors in 62 patients: 30 aggressive an 32 relatively nonaggressive tumors. Twenty patients were excluded from anal ysis owing to insufficient surgical data, tumor too small for accurate asse ssment, or technical problems. There were no significant differences betwee n aggressive and nonaggressive tumors in terms of the first-pass contrast-e nhancement parameters of slope (2.0 vs 2.1 arbitrary signal intensity units per second, P > .5) or amplitude (24.8 vs 27.8 arbitrary units, P > .2). CONCLUSION: Dynamic contrast-enhanced MR imaging does not facilitate differ entiation between aggressive and nonaggressive tumors and therefore has no clinical role in assisting in treatment decisions in patients who are candi dates for radical hysterectomy.