title: Reliability of magnetic resonance imaging for bladder or rectum invasion in cervical cancer.
abstract: OBJECTIVE
  To find out whether a negative finding on magnetic resonance imaging (MRI) can rule out bladder or rectum mucosal invasion safely without cystoscopy or sigmoidoscopy.
  
  
  METHODS
  We retrospectively reviewed the medical records of patients with cervical cancer between January 2005 and December 2009. MRI findings on bladder or rectum were classified as follows: (1) definite evidence of mucosal invasion, (2) suggestive of mucosal invasion or (3) no evidence of mucosal invasion. We correlated MRI findings with the cystoscopy and sigmoidoscopy findings.
  
  
  RESULTS
  A total of 257 patients were enrolled in this study. Sixteen patients had at least suspicious bladder invasion, and 1 patient had definite rectal invasion on MRI. Of these 17 patients, 6 patients had actual bladder mucosa invasion, and 1 patient had rectal mucosa invasion. The remaining 240 had negative MRI, cystoscopy and sigmoidoscopy findings. The MRI sensitivity, specificity, positive predictive value, negative predictive value and accuracy of bladder or rectum mucosal invasion were 100%, 96.0%, 41.25%, 100% and 96.1%, respectively.
  
  
  CONCLUSIONS
  Skipping cystoscopy or sigmoidoscopy based on the absence of invasion on MRI is safe enough without concern for understaging.
authors.affiliation: Department of Obstetrics and Gynecology, Myongji Hospital, Kwandong University School of Medicine, Goyang, Korea.
authors.forename: Woo Young
authors.initials: WY
authors.lastname: Kim
authors.forename: Suk-Joon
authors.initials: SJ
authors.lastname: Chang
authors.forename: Ki-Hong
authors.initials: KH
authors.lastname: Chang
authors.forename: Seung-Chul
authors.initials: SC
authors.lastname: Yoo
authors.forename: Eun Ju
authors.initials: EJ
authors.lastname: Lee
authors.forename: Hee-Sug
authors.initials: HS
authors.lastname: Ryu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003558:Cystoscopy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D012004:Rectal Neoplasms / Q000556:secondary*; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012812:Sigmoidoscopy; D001749:Urinary Bladder Neoplasms / Q000556:secondary*; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000473:pathology*; D055815:Young Adult