J Gynecol Oncol.  2008 Jun;19(2):108-112. 10.3802/jgo.2008.19.2.108.

Value of pelvic examination and imaging modality for the evaluation of tumor size in cervical cancer

• Lee YK
• Han SS
• Kim JW
• Park NH
• Song YS
• Kang SB

• KMID: 2129909
• DOI: http://doi.org/10.3802/jgo.2008.19.2.108

Abstract

OBJECTIVE
The purpose of this study was to compare the accuracy of pelvic examination versus imaging modality such as computed tomography (CT) or magnetic resonance imaging (MRI) in the measurement of the tumor size of invasive cervical carcinoma based on pathologic findings.
METHODS
Patients with stage Ib-II cervical cancer who underwent primary surgical treatment between January 2003 and December 2005 were evaluated retrospectively. One hundred three consecutive patients aged 24 to 81 years (mean age, 50.6 years), who had not received any treatment previously were included in this study. Accuracy of preoperative CT or MRI versus pelvic examination in the measurement of tumor size was compared based on pathologic findings. All patients were examined and staged clinically by the gynecologic oncologist. Surgery was performed within 2 weeks after imaging studies. The data were analyzed using descriptive statistics.
RESULTS
The largest diameter of the tumor measured by pathologic findings was 2.76+/-1.76 cm. Based on pathologic findings, accuracy was estimated by the degree of agreement with a difference of <0.5 or 1.0 cm between the measurements of tumor size obtained by pelvic examination and imaging modality. Pelvic examination and imaging modality had an accuracy of 46.6% and 39.8%, respectively, with a difference of <0.5 cm, and an accuracy of 72.8% and 55.3%, respectively, with a difference of <1.0 cm. Correlation with pathologic findings was higher for pelvic examination (r(s)=0.680) than for imaging modality (r(s)=0.410). In determining the size of tumor mass differentiating >4.0 cm from < or =4.0 cm, imaging modality showed higher accuracy than pelvic examination.
CONCLUSION
For the patients with stage Ib to II cervical cancer, pelvic examination is superior to imaging modality with regard to evaluation of the tumor size. However, imaging modality may be accurate for evaluating bulky tumors of cervical cancer.

Keyword

Uterine cervical neoplasms; Pelvic examination; Computed tomography; Magnetic resonance imaging

MeSH Terms

Aged
Gynecological Examination
Humans
Magnetic Resonance Imaging
Retrospective Studies
Uterine Cervical Neoplasms

Figure

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  Fig. 1 Correlation between the measurements estimated by pelvic examination and imaging modality based on pathologic findings. (A) Scattergram between the measurements estimated by pelvic examination and pathologic findings in patients with cervical cancer. (B) Scattergram between the measurements estimated by imaging modality and pathologic findings in patients with cervical cancer.

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