title: Evaluation of carcinoma cervix using magnetic resonance imaging: correlation with clinical FIGO staging and impact on management.
abstract: OBJECTIVE
  To evaluate carcinoma of the cervix using magnetic resonance imaging (MRI), correlate with clinical approach of International Federation of Gynecology and Obstetrics (FIGO) staging system and to study the impact of MRI findings on patient management.
  
  
  METHODS
  Pathologically confirmed, 75 cases of carcinoma cervix referred to our institute from April 2007 to March 2008 were prospectively studied. Clinical FIGO stage was assigned to each patient by gynaecologists blinded to MRI findings. MRI stage (based on FIGO and TNM) was allotted by radiologists blinded to clinicopathological details. For patients who were operated, histopathological stage was taken as gold standard. For patients who were not operated, gynaecologists decided on a gold standard stage based on all available clinical and imaging data. MR staging was correlated with FIGO staging, with focus on significant alterations in treatment strategy caused due to MRI findings.
  
  
  RESULTS
  MRI staging had an accuracy of 89.3% (67/75), while clinical FIGO staging had 61.3% (46/75) accuracy. MRI staging and FIGO staging concurred in 65.6% of the patients and differed in 34.4% of the patients. In about 30.6% (23/75) of the patients, there were relevant additional MRI findings not suspected clinically. The common significant MRI findings were detection of pelvic lymphadenopathy and clinically unsuspected bowel/bladder invasion. The management protocol was significantly altered in 86.9% (20/23) of the patients with additional MRI findings constituting 26.6% (20/75) of the total population.
  
  
  CONCLUSIONS
  MRI is highly accurate in evaluating carcinoma of the cervix. MRI findings significantly altered therapeutic decisions in 26.6% of the patients. MRI should be considered prior to treatment planning in every patient.
authors.affiliation: Department of Radiology, Dr B Barooah Cancer Institute, Guwahati, India. drniludhoot@gmail.com
authors.forename: Nilu Malpani
authors.initials: NM
authors.lastname: Dhoot
authors.forename: Vinay
authors.initials: V
authors.lastname: Kumar
authors.forename: Atul
authors.initials: A
authors.lastname: Shinagare
authors.forename: Amal Chandra
authors.initials: AC
authors.lastname: Kataki
authors.forename: Debabrata
authors.initials: D
authors.lastname: Barmon
authors.forename: Utpal
authors.initials: U
authors.lastname: Bhuyan
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011446:Prospective Studies; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000628:therapy