Evaluation of maximal tumor diameter of primary uterine cervical cancer with conventional and dynamic magnetic resonance imaging and clinical palpation in comparison to whole mount specimen findings

Purpose: The maximal tumor diameter of primary uterine cervical cancer is n ext to lymph- and hemangiosis, the FIGO stage and the lymphnode status the most important prognosis factor concerning patients' survival. Therefore th e efficiency of magnetic resonance imaging (MRI) for the pretherapeutic eva luation of tumor diameter in case of primary uterine cervical cancer is of interest. Material and Methods: In our study thirty-one patients with biopsy proven primary uterin e cervical cancer underwent dynamic and conventional T-1- and T-2-weighted MRI to evaluate the maximal tumor diameter. This parameter was additionally seized by clinical palpation. The results were correlated with the histopa thological whale mount specimen as gold standard. Results: No significant difference exists between the MRI techniques and th e clinical palpation in assessment of the maximal tumor diameter of cervica l cancer (p = 0.60) in comparison to the whole mount specimen findings. The T-2-weighted MRI showed the highest correlation (r = 0.88) up to FIGO IIB disease followed by T-1-weighted MRI (r = 0.80), contrast-enhanced dynamic MRI (r = 0.79) and clinical palpation (r = 0.63). In advanced cervical canc er disease greater than FIGO IIB the highest correlation could be observed with clinical palpation (r = 0.84). The other correlation coefficients were r = 0.76 for dynamic MRI, r = 0.74 for T-2-weighted MRI and r = 0.73 for T -1-weighted MRI. Conclusions: The MRI procedures offer no evident advantage in relation to c linical palpation to determine the maximal tumor diameter of primary uterin e cervical cancer and seems not to be indicated for this parameter only.