Role of MR imaging in the selection of patients with early cervical carcinoma for fertility-preserving surgery: initial experience.
OBJECTIVE
To assess whether magnetic resonance (MR) imaging can be used for reliable prediction of proximal extension of cervical carcinoma into the myometrium.


METHODS
Thirty patients with early cervical carcinoma underwent MR imaging with use of a 1.5-T magnet prior to surgery. The MR images were analyzed by two radiologists, unaware of the histopathologic findings, for the relationship of the tumor to the internal os and extension of the tumor into the myometrium. Findings at MR imaging were compared with those at histopathologic examination.


RESULTS
At MR imaging, 24 patients were considered not to have tumor extension proximal to the internal os and into the myometrium. All tumors were confirmed histopathologically. In six patients thought to have myometrial tumor invasion at MR imaging, five tumors were confirmed histopathologically; in one, tumor extended up to the internal os but did not involve the myometrium.


CONCLUSIONS
This is a small study, but MR imaging appears accurate in the prediction of myometrial tumor involvement and in showing the relationship of cervical carcinoma to the internal os and, hence, the patient's suitability for trachelectomy.
Peppercorn
P D
PD
Department of Radiology, St. Bartholomew's Hospital, West Smithfield, London, UK.
Jeyarajah
A R
AR
Woolas
R
R
Shepherd
J H
JH
Oram
D H
DH
Jacobs
I J
IJ
Armstrong
P
P
Lowe
D
D
Reznek
R H
RH
D000328:Adult; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D007247:Infertility, Female / Q000517:prevention & control*; D008279:Magnetic Resonance Imaging; D009215:Myometrium / Q000473:pathology; D009361:Neoplasm Invasiveness; D018579:Patient Selection; D011237:Predictive Value of Tests; D011446:Prospective Studies; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery*
D003287:Contrast Media; D019786:Gadolinium DTPA