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Role of magnetic resonance imaging in predicting pathologic findings in cervical cancer


Obstetrics & Gynecology International Journal
Quiroga Francisca, De Leon Mariana, Ballarino Bianca, Garcia Balcarce Tomas, Ramilo Pablo Tomas, Camargo Alfredo, Bianchi Federico, Boixart Agustin, Apartin Ludmila

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Abstract

Objective: To evaluate the role of magnetic resonance imaging in the assessment of disease extent and staging of cervical cancer, and to analyze its correlation with histopathologic findings in surgically treated patients. 
Methods: A retrospective observational single-center study was conducted including patients with cervical cancer who underwent surgical treatment between March 2017 and February 2022. MRI findings performed before or after diagnostic conization were reviewed and compared with definitive histopathologic results. Tumor size, parametrial involvement, and lymph node status were analyzed. Diagnostic performance parameters were calculated. 
Results: Thirty-eight patients were included, with a mean age of 42.4 years. Histology was squamous cell carcinoma in 79% and adenocarcinoma in 21%. MRI demonstrated a sensitivity of 100% and a specificity of 81% for parametrial involvement, with a high negative predictive value (100%). For lymph node assessment, MRI showed low sensitivity (14%) but high specificity (96%). Regarding tumor size, MRI demonstrated a sensitivity of 57% and a specificity of 96% for tumors larger than 4 cm. For tumors smaller than 2 cm, MRI achieved a sensitivity of 60% and a specificity of 78%. 
Conclusion: Magnetic resonance imaging is a valuable tool for the local staging of cervical cancer, showing high accuracy for assessing tumor size and excluding parametrial involvement. While its sensitivity for detecting lymph node metastases remains limited, MRI provides important complementary information for surgical planning and patient selection, particularly in centers with expertise in gynecologic imaging.

Keywords

magnetic resonance imaging, cervical cancer, lymph node, tumor

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