Role of MR imaging in the selection of patients with early cervical carcinoma for fertility-preserving surgery: Initial experience

PURPOSE: To assess whether magnetic resonance (MR) imaging can be used for reliable prediction of proximal extension of cervical carcinoma into the my ometrium. MATERIALS AND METHODS: Thirty patients with early cervical carcinoma underw ent MR imaging with use of a 1.5-T magnet prior to surgery. The MR images w ere analyzed by two radiologists, unaware of the histopathologic findings, for the relationship of the tumor to the internal os and extension of the t umor into the myometrium. Findings at MR imaging were compared with those a t histopathologic examination. RESULTS: At MR imaging, 24 patients were considered not to have tumor exten sion proximal to the internal os and into the myometrium. All tumors were c onfirmed histopathologically. In six patients thought to have myometrial tu mor invasion at MR imaging, five tumors were confirmed histopathologically; in one, tumor extended up to the internal os but did not involve the myome trium. CONCLUSION: This is a small study, but MR imaging appears accurate in the p rediction of myometrial tumor involvement and in showing the relationship o f cervical carcinoma to the internal os and, hence, the patient's suitabili ty for trachelectomy.