Preoperative staging of cervical carcinoma with MR imaging: a reappraisal of diagnostic accuracy and pitfalls

The purpose of this study was to assess the diagnostic accuracy and pitfall s of MR imaging in preoperative staging of cervical cancer. Magnetic resona nce imaging was performed to determine the tumor staging for 41 patients wi th cervical carcinoma emphasizing tumor size, parametrial invasion, vaginal invasion, and lymph node metastases. According to the correlation of MR fi ndings with surgical-pathological features, there was less than 5 mm discre pancy in the size in 29 of 34 tumors (85.3%) that were larger than 1 cm. In assessing parametrial invasion, vaginal invasion and lymph node metastases . MR imaging had an accuracy of 95, 83, and 86%, respectively. In determini ng stage of disease and differentiating operable (less than or equal to sta ge IIA) from advanced disease (>stage IIB), MR imaging had an accuracy of 8 2.9 and 93%. Pitfalls leading to staging errors included difficulties in di fferentiating cancer foci from surrounding tissue edema and detecting micro scopic tumor extension. Magnetic resonance imaging is accurate in the evalu ation of parametrial invasion and differentiation of operable from advanced disease. The ability of MR imaging to detect microscopic extra-cervical tu mor extension and differentiate cancer foci from surrounding tissue edema i s not as reliable.