Tumor diameter and volume assessed by magnetic resonance imaging in the prediction of outcome for invasive cervical cancer

Objective. The aim of this study was to evaluate the predictive value of pr etherapeutic magnetic resonance imaging (MRI)-based measurements of tumor d iameter and volume with regard to recurrent disease. Methods. NM on 0.5- or 1.5-T scanners was performed in 126 consecutive wome n with invasive carcinoma of the uterine cervix. Initial tumor diameter and volume were determined on T-2-weighted images; volume was calculated by th e standard technique of multiplying the sum of the areas by the slice thick ness. Patients were treated by radical surgery, radiotherapy, or a combined approach based on clinical International Federation of Gynecology and Obst etrics (FIGO) stage and individual patient criteria. Clinical data (patient age and FIGO stage), MRI-derived tumor dimensions (diameter and volume), a nd histological findings (tumor invasion depth and lymph-node involvement) were associated and linked to patient outcome. Results. MRI-based tumor diameter correlated strongly with histological tum or invasion depth and lymph-node status (P < 0.01 and P = 0.01) while tumor volume on MRI was significantly associated only with tumor invasion depth into adjacent tissues (P < 0.01). Univariate analysis demonstrated graphica lly that MRI-derived tumor diameter and volume and clinical FIGO stage are associated with progression-free survival. Correlation analysis showed a st rong association between MRI-derived tumor diameter and volume on MRI (r = 68%, P < 0.01) and also demonstrated a correlation between tumor diameter o n MRI and FIGO stage Ib (Ib1 versus Ib2) cervical tumors (r = 46.7%, P < 0. 01). Conclusion. Tumor diameter and volume, determined by pretreatment MRI exami nations, predict progression-free survival for patients with invasive cervi cal carcinoma. This study demonstrates the value of MRI as an adjunct to cl inical evaluation of invasive cervical cancer, providing more complete asse ssment of morphological risk factors important in patient prognosis and tre atment planning. (C) 2001 Academic Press.