The Clinical Significance of Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) in Pretreatment Evaluation of Invasive Cervical Cancer

Kim, Eon Ah; Choi, Hae Young; Lee, Sun Ok; Kim, Yoon Su; Park, Han Moie; Moon, Hye Sung; Kim, Seung Cheol; Jun, Sun Hee; Kim, Jong Il

Abstract

OBJECTIVE
This study aimed to evaluate the clinical significance of CT or MRI in detecting parametrial invasion, pelvic or para-aortic lymph node metastasis. We also evaluated whether IVP, cystoscopy and sigmoiodoscopy could be replaced by CT or MRI.
METHODS
The medical records of 130 patients with invasive cervical cancer who were histologically diagnosed from Jan 1994 to Feb 1999 at MokDong Hospital were reviewed. We compared the results of physical examination, CT or MRI, and surgical finding in detecting the prarmetiral invasion and pelvic or para-aortic LN metastasis. We also compared the results of IVP, cystoscopy, sigmoidoscopy with the finding of CT or MRI. Fishers exact test was used and p<0.05 was regarded as statistically significant.
RESULTS
CT or MRI were clinically significant in detecting parametrial invasion, pelvic or para-aortic LN metastasis, ureter, bladder and rectosigmoid invasion (p<0.005). In detecting parametrial invasion and pelvic or para-aortic LN metastasis, the positive predictive value of CT or MRI were 33.3%, 70% and the negative predictive value were 98%, 91.5%, respectively. In detecting ureter, bladder, and rectosigmoid invasion, the positive predictive value of CT or MRI were 62.5%, 26% and 17% and the negative predictive value were 98%, 100% and 100%, respectively.
CONCLUSION
CT or MRI can provide useful information as to parametrial invasion and pelvic or para- aortic lymph node metastasis. CT or MRI can substitude for IVP, cystoscopy, sigmoidoscopy. And only if bladder and rectosigmoid invasion is suspected on MRI, we must perform cystoscopy and sigmoidoscopy to confirm the invasion. Because CT is either superior or equal to IVP in evaluation of the urinary tract, it is not necessary to perform IVP when CT is performed.