Staging and diagnosis of carcinoma of the uterine cervix: A MR imaging study

Abstract

The incidence of carcinoma cervix was 86-90% of all genital cancer of women in India. Estimation of disease extent and staging is crucial in the management of carcinoma cervix. Evaluation of disease staging by cyctoscopy, Sigmoidoscopy and pelvic examination provided insufficient information. Hence, MRI and CT has become accurate imaging modalities for clinical staging of carcinoma cervix. Among these, MRI is the accurate imaging modality in the assessment of diseae staging and extent. This study was aimed to assess the efficacy of MR imaging in the diagnosis and staging of carcinoma cervix. A total 90 cases newly diagnosed and histo-pathologically confirmed with carcinoma of uterine cervix and treated with chemoradiotherapy were included. International Federation of Gynecology and Obstetrics (FIGO) staing was applied to MRI grading of the tumor. All the study participants were subjected to MRI pelvis perforemed with 1.5 tesla machine. Suspected masses were seen in 86.84% newly diagnosed cases and in 80.7% recurrent cases. The diagnostic accuracy, sensitivity, specificity, PPV and NPV in newly diagnosed cases was 89.82%, 90.20%, 18%, 93.14% and 95.45% respectively. Whereas in recurrent cases, diagnostic accuracy, sensitivity, specificity, PPV and NPV was 68.54%, 91%, 42%, 72.36% and 76% respectively. MR imaging is the better diagnostic modality than clinical examination in the tumor staging, extension of disease and assessment of treatment response in the carcinoma cervix.