Original scientific paper
Primary Uterine Cervical Cancer: Correlation of Preoperative Magnetic Resonance Imaging and Clinical Staging (FIGO) with Histopathology Findings
Zdenko Kraljević
; University of Zagreb, »Sestre milosrdnice« University Hospital Center, Department of Gynaecology and Obstetrics, Zagreb,
Klaudija Visković
orcid.org/0000-0002-5927-3201
; University of Zagreb, »Sestre milosrdnice« University Hospital Center, Department of Gynaecology and Obstetrics, Zagreb,
Mario Ledinsky
; University of Zagreb, »Sestre milosrdnice« University Hospital Center, Department of Gynaecology and Obstetrics, Zagreb,
Dijana Zadravec
; University of Zagreb, »Sestre milosrdnice« University Hospital Center, Department of Diagnostic and Interventional Radiology,
Ivan Grbavac
; University of Zagreb, »Sestre milosrdnice« University Hospital Center, Department of Gynaecology and Obstetrics, Zagreb,
Marijana Bilandžija
; University of Zagreb, »Sestre milosrdnice« University Hospital Center, Department of Gynaecology and Obstetrics, Zagreb,
Hrvojka Soljačić-Vraneš
; University of Zagreb, »Sestre milosrdnice« University Hospital Center, Department of Gynaecology and Obstetrics, Zagreb,
Krunoslav Kuna
; University of Zagreb, »Sestre milosrdnice« University Hospital Center, Department of Gynaecology and Obstetrics, Zagreb,
Ksenija Klasnić
; University of Zagreb, Faculty of Humanities and Social Sciences, Department of Sociology, Zagreb, Croatia
Ivan Krolo
; University of Zagreb, »Sestre milosrdnice« University Hospital Center, Department of Diagnostic and Interventional Radiology,
Abstract
The most commonly used staging system for cervical cancer is based on the International Federation of Gynaecology and Obstetrics (FIGO) staging system.Magnetic resonance imaging (MRI) has been accepted as the optimal tool for evaluation of the main prognostic factors and selection of therapeutic strategy. The purpose of this study was to compare the preoperative clinical examination FIGO staging findings with MRI and postoperative pathology report in females with primary cancer of the cervix. The study prospectively included 46 females consecutively hospitalized at the Department of Gynaecology and Obstetrics at the »Sestre milosrdnice« University Hospital Center in Zagreb. Interviews, clinical examination, transvaginal ultrasound and MRI were performed in all patients. In selected patients the surgical procedure was done and the correlation of clinical findings according to FIGO classifications, MRI and histopathological findings was
completed. According to FIGO classification, positive clinical findings for stage IIA were found in 26/46 (55.5%) and stage IIB in 20/46 (44.5%) patients. FIGO MR modified classification confirmed stage IIA in 30/46 (66.6%) and stage IIB in 16/46 (33.4%) patients. Surgery (Wertheim radical hysterectomy with bilateral pelvic and selective para-aortic lymphadenectomy) was performed in 33/46 (71%) patients with clinically, MR, cytologically and pathohistologically confirmed findings of cervical cancer: 26 patients with IIA clinically FIGO stage and 7 with IIB stage. MRI examination proved better than clinical examination in staging of cervical carcinoma with 90.9% versus 79.0% accuracy rate. We suggest the
application of the following MR protocol in all clinically staged FIGO IIA and IIB patients: T1W, T2WI and postcontrast dynamic T1WI after 3 and 60 seconds and after 5 minutes, performed on 1.5T MR machine.
Keywords
cervical cancer; magnetic resonance imaging; staging
Hrčak ID:
104664
URI
Publication date:
1.7.2013.
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