FAST DYNAMIC CONTRAST-ENHANCED COLOR-CODED MRI IN UTERINE CERVIX CARCINOMA - USEFUL FOR TUMOR STAGING

Objective: To quantify first-pass enhancement of cervix carcinoma usin g fast dynamic MRI. To assess the accuracy of dynamic contrast-enhance d colour-coded MRI for determining tumour invasion into surrounding pe lvic tissues. Methods: Gadolinium enhanced dynamic MRI at one image ev ery 2s was performed in 47 patients with cervical carcinoma and five c ontrols. First-pass contrast enhancement of cervix carcinoma and surro unding pelvic tissues was quantified. Automated colour-coded images me re constructed using the dynamic parameters slope, amplitude and timin g of enhancement. Of 47 patients, 28 underwent surgery and colour code d images were correlated with histological findings. Results: First-pa ss contrast enhancement imaging of cervix carcinoma required a tempora l resolution of dynamic MRI of one image every 3-4 s. Cervix carcinoma first-pass was more rapid and intense than that of other pelvic tissu es (P<0.001) with the exception of normal myometrium (P>0.05). Binary colour coding, however, was not reliable for tumour delineation or for accurate assessment of tumour invasion into the parametria or the bla dder wall. Overestimation of the extent of tumour invasion occurred in 15, 16 and nine out of 28 patients, respectively, using amplitude, sl ope and timing of enhancement as parameters. Conclusion: Dynamic contr ast-enhanced colour-coded MRI of cervix carcinoma has limited value fo r assessing the extent of tumour spread and tumour staging.