Diagnostic Accuracy of MRI for Cervical Malignancy with Histopathologic Correlation

Mamdouh, Ahmed Mohamed; Saad, Amr; Morsi, Hassan

doi:10.21608/egyfs.2024.388585

	Diagnostic Accuracy of MRI for Cervical Malignancy with Histopathologic Correlation
The Egyptian Journal of Fertility and Sterility
Volume 28, Issue 5 - Serial Number 11106352, September 2024, Page 3-9 PDF (264.34 K)
Document Type: Original Article
DOI: 10.21608/egyfs.2024.388585
View on SCiNiTO
Authors
Ahmed Mohamed Mamdouh¹; Amr Saad²; Hassan Morsi ¹^{, 3}
¹Assistant Professor of Obstetrics & Gynaecology, Ain Shams University
²Lecturer of Obstetrics & Gynaecology, Ain Shams University
³Obstetrics & Gynaecology Department, Abbassia Square, Cairo
Abstract
Background and Aim: The determination of lymph node metastases, parametrial invasion, and pelvic side wall invasion—all known to be signiﬁcant prognostic factors—as well as the precise measurement of tumor size present the greatest challenges in cervical cancer. The only gynaecological cancer that is currently primarily staged clinically, according to the FIGO classiﬁcation, is cervical cancer. The aim of this work is to evaluate the role of MRI in the accurate staging of cancer cervix compared to clinical FIGO staging. Methods: This prospective study included 21 patients (19 with primarily untreated pathologically proven cervical cancer who underwent pretreatment MRI and 2 post chemo-radiotherapy cases who underwent post-treatment MRI). Results: This study found that 100% sensitivity and 100% speciﬁcity in detecting parametrial invasion contrasts with clinical staging's 20% sensitivity. Vaginal invasion may be detected with 100% sensitivity in both stage IIA and IIIA using MRI, which is very sensitive. A hyperintense vaginal thickening (tumor) or the mass itself next to the vaginal wall are the two most clear indicators of vaginal involvement on high-resolution T2-weighted sequences. These sequences also indicate the segmental discontinuity of the typical hypointense signal of the vaginal wall. Stage IIa is represented by vaginal invasion, and stage IIIa is represented when this invasion reaches the lower vaginal third. Conclusions: Research has demonstrated that MRI is superior to clinical examinations. When used as the ﬁrst staging technique, it enables accurate evaluation of the tumor's volume and extension, which improves ﬁeld planning for external pelvic radiation and brachytherapy.
Keywords
Key words: MRI; cervical cancer; histopathology.


Statistics Article View: 123 PDF Download: 93