OC24.01: Early stage cervical cancer: tumor delineation by magnetic resonance imaging and ultrasound in a preoperative staging, verified by pathological results: the results of an European multicentre trial

ObjectiveThe aim of this study is to evaluate the accuracy of magnetic resonance imaging (MRI) in the preoperative assessments of primary tumor size, parametrial invasion, and pelvic lymph node metastasis in patients with early-stage cervical cancer.Materials and MethodsA cohort of 125 patients with International Federation of Gynecology and Obstetrics stage IA2 to IIA cervical cancer who had preoperative MRI and underwent radical hysterectomy were enrolled and analyzed. The accuracy of preoperative MRI scan and pelvic examination in the measurement of tumor size was assessed based on postoperative measurement and pathologic findings. The accuracy of detection of lymph node status and parametrial invasion was also assessed by comparing the MRI and pathologic findings.ResultsThe mean diameter of the tumor size measured by postoperative measurement, MRI, and pelvic examination was 2.97 ± 1.39 cm, 2.78 ± 1.24 cm, and 1.97 ± 1.70 cm, respectively. There were significant differences in the mean diameter of the tumor size between pelvic examinations and MRI scan or postoperative measurement (P < 0.0001). Based on postoperative measurement findings, accuracy of tumor size measurement between pelvic examination and MRI was determined by the degree of agreement with a difference of less than 0.5 or 1.0 cm. Pelvic examination and MRI had an accuracy of 24.75% and 39.60%, respectively, with a difference of less than 0.5 cm, and had an accuracy of 43.56% and 61.39%, respectively, with a difference of less than 1.0 cm. Correlation with postoperative measurement in tumor size was higher for MRI (r[s] = 0.481) than that for pelvic examination (r[s] = 0.362). The sensitivity, specificity, and accuracy of MRI in detecting lymph node metastasis were 27.78%, 85.98%, 77.60%, respectively. The negative predictive value of MRI in detecting parametrial invasion is 100%.ConclusionsMagnetic resonance imaging is an accurate noninvasive modality for preoperative evaluation of tumor size and also gives important information to parametrial invasion and lymph node status in patients with early-stage cervical cancer.

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EPV079/#495 Accuracy of magnetic resonance imaging for preoperative prediction of pathologic tumor size and the need of adjuvant radiotherapy in early-stage cervical cancer

10.1136/ijgc-2021-igcs.147 ◽

2021 ◽

Author(s):

D Kim ◽

U Kim ◽

SJ Park ◽

M Lee ◽

HS Kim ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Cervical Cancer ◽

Magnetic Resonance ◽

Tumor Size ◽

Adjuvant Radiotherapy ◽

Early Stage ◽

Resonance Imaging ◽

Preoperative Prediction ◽

Early Stage Cervical Cancer

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Early stage cervical cancer: role of magnetic resonance imaging after conization in determining residual tumor

Acta Radiologica ◽

10.1177/0284185115620948 ◽

2016 ◽

Vol 57 (10) ◽

pp. 1268-1276 ◽

Cited By ~ 4

Author(s):

Sungmin Woo ◽

Hye Sung Kim ◽

Hyun Hoon Chung ◽

Sang Youn Kim ◽

Seung Hyup Kim ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Cervical Cancer ◽

Magnetic Resonance ◽

Early Stage ◽

Residual Tumor ◽

Resonance Imaging ◽

Early Stage Cervical Cancer

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The role of magnetic resonance imaging in determining the proximal extension of early stage cervical cancer to the internal os

European Journal of Radiology ◽

10.1016/j.ejrad.2009.06.006 ◽

2011 ◽

Vol 78 (1) ◽

pp. 60-64 ◽

Cited By ~ 11

Author(s):

Shandra Bipat ◽

Ryan A. van den Berg ◽

Jacobus van der Velden ◽

Jaap Stoker ◽

Anje M. Spijkerboer

Keyword(s):

Magnetic Resonance Imaging ◽

Cervical Cancer ◽

Magnetic Resonance ◽

Early Stage ◽

Resonance Imaging ◽

Early Stage Cervical Cancer ◽

Proximal Extension

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Multiparametric magnetic resonance imaging-derived radiomics for the prediction of disease-free survival in early-stage squamous cervical cancer

European Radiology ◽

10.1007/s00330-021-08326-6 ◽

2021 ◽

Author(s):

Yan Zhou ◽

Hai-Lei Gu ◽

Xin-Lu Zhang ◽

Zhong-Fu Tian ◽

Xiao-Quan Xu ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Cervical Cancer ◽

Magnetic Resonance ◽

Early Stage ◽

Disease Free Survival ◽

Resonance Imaging ◽

Free Survival ◽

Multiparametric Magnetic Resonance Imaging ◽

Squamous Cervical Cancer ◽

Disease Free

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Accuracy of Ultrasonography and Magnetic Resonance Imaging for Preoperative Staging of Cervical Cancer—Analysis of Patients from the Prospective Study on Total Mesometrial Resection

Diagnostics ◽

10.3390/diagnostics11101749 ◽

2021 ◽

Vol 11 (10) ◽

pp. 1749

Author(s):

Maciej Stukan ◽

Paul Buderath ◽

Bartosz Szulczyński ◽

Jacek Gębicki ◽

Rainer Kimmig

Keyword(s):

Magnetic Resonance Imaging ◽

Cervical Cancer ◽

Magnetic Resonance ◽

Measurement Errors ◽

Tumor Staging ◽

Preoperative Staging ◽

Resonance Imaging ◽

Uterine Corpus ◽

Gynecology And Obstetrics ◽

Imaging Results

We aimed to evaluate the accuracy of ultrasonography with gynecologic examination performed by a gynecological oncologist and magnetic resonance imaging (MRI) interpreted by a radiologist for the local and regional staging of patients with early-stage cervical cancer. The study was a single-site sub-analysis of the multi-institutional prospective, observational Total Mesometrial Resection (TMMR) Register Study, which included all consecutive study patients from Gdynia Oncology Center. Imaging results were compared with pathology findings. A total of 58 consecutive patients were enrolled, and 50 underwent both ultrasonography and MRI. The accuracy of tumor detection and measurement errors was comparable across ultrasonography and MRI. There were no significant differences between ultrasonography and MRI in the accuracy of detecting parametrial involvement (92%, confidence interval (CI) 84–100% vs. 76%, CI 64–88%, p = 0.3), uterine corpus infiltration (94%, CI 87–100% vs. 86%, CI 76–96%, p = 0.3), and vaginal fornix involvement (96%, CI 91–100% vs. 76%, CI 64–88%, p = 0.3). The importance of uterine corpus involvement for the first-line lymph node metastases was presented in few cases. The accuracy of ultrasonography was higher than MRI for correctly predicting tumor stage: International Federation of Gynecology and Obstetrics (FIGO)–2018: 69%, CI 57–81% vs. 42%, CI 28–56%, p = 0.002, T (from TNM system): 79%, CI 69–90% vs. 52%, CI 38–66%, p = 0.0005, and ontogenetic tumor staging: 88%, CI 80–96% vs. 70%, CI 57–83%, p = 0.005. For patients with cervical cancer who are eligible for TMMR and therapeutic lymphadenectomy, the accuracy of ultrasonography performed by gynecological oncologists is not inferior to that of MRI interpreted by a radiologist for assessing specific local parameters, and is more accurate for local staging of the disease and is thus more clinically useful for planning adequate surgical treatment.

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