title: Early stage cervical cancer: role of magnetic resonance imaging after conization in determining residual tumor.
abstract: BACKGROUND
  Although magnetic resonance imaging (MRI) is currently indispensable in the management of cervical cancer, its role in determining residual tumor in patients with cervical cancer after conization is not well known.
  
  
  OBJECTIVE
  To evaluate the value of MRI after conization in determining residual tumor in patients with FIGO stage IA-IB1 cervical cancer.
  
  
  METHODS
  In this retrospective study, 55 patients underwent conization followed by preoperative MRI and definitive surgery. Two radiologists evaluated the presence of residual tumor on MRI. MRI and preoperative clinical variables were compared between patients with and without residual tumor at final pathology using Student's t-test or Chi-square test. Association between variables and the presence of residual tumor was assessed using logistic regression analyses and receiver operating characteristic (ROC) curves.
  
  
  RESULTS
  Residual tumor at final pathology was found in 30 (54.5%) patients. Patients with residual tumor were older, had greater SCC antigen, and more frequently had positive conization margins and identifiable tumor on MRI (P < 0.008). Multivariate analysis showed that age (P = 0.008; odds ratio [OR] = 1.140), positive conization margin (P = 0.016; OR = 11.919), and identifiable tumor on MRI (P = 0.038; OR = 6.926) were independently predictive of residual tumor. Areas under the curve (AUCs) calculated with age (0.693), SCC antigen (0.755), and identifiable tumor on MRI (0.727) were greater than lymphovascular space invasion (0.517) and histological subtype (0.520, P ≤ 0.049). Otherwise, there were no significant differences in the AUCs derived from different variables (P = 0.053-0.970).
  
  
  CONCLUSIONS
  Identifiable tumor on MRI after conization in patients with early stage cervical cancer was an independent predictor of residual tumor at final pathology.
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Sungmin
authors.initials: S
authors.lastname: Woo
authors.affiliation: Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Hye Sung
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Hyun Hoon
authors.initials: HH
authors.lastname: Chung
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Sang Youn
authors.initials: SY
authors.lastname: Kim
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea Institute of Radiation Medicine and Kidney Research Institute, Seoul National University Medical Research Center, Seoul, Republic of Korea.
authors.forename: Seung Hyup
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea Institute of Radiation Medicine and Kidney Research Institute, Seoul National University Medical Research Center, Seoul, Republic of Korea radjycho@snu.ac.kr.
authors.forename: Jeong Yeon
authors.initials: JY
authors.lastname: Cho
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019092:Conization; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000000981:diagnostic imaging* / Q000473:pathology*; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA
keywords: Cervical cancer; conization; magnetic resonance imaging (MRI); residual tumor