Negative MRI findings with invasive cervical biopsy may indicate stage IA cervical carcinoma

Objective. We attempted to prospectively determine the role of magnetic res onance imaging (MRI) in very early cervical cancer. Study design. T2-weighted and T1-dynamic enhanced images from patients with invasive or noninvasive lesions of the cervix were reviewed by two radiolo gists who had no clinical information on these patients. At least 12 longit udinal sections prepared from the surgically removed cervix were reviewed b y a pathologist. The correlation between MRI and histological findings was analyzed in terms of depth of invasion. Results. Seventy-nine cases were entered into the study and 75 were evaluab le. Accuracy of T2 MR images for invasive and noninvasive disease by Radiol ogist 1 and Radiologist 2 was 0.8533 and 0.7733, respectively. Accuracy was greater (0.9867 and 0.9467, respectively) for the detection of noninvasive plus microinvasive lesions less than or equal to5 mm vs invasive lesions > 5 mm. Dynamic technique provided only limited additional value in the detec tion of microinvasive cervical carcinoma. Conclusion. Simple T2 MRI is useful in differentiating noninvasive or micro invasive cervical lesions from invasive cervical carcinoma of the cervix >5 mm. (C) 2000 Academic Press.