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Staging of invasive cervical carcinoma and of pelvic lymph nodes by high resolution MRI with a phased-array coil in comparison with pathological findings.

PURPOSE
Our goal was to stage invasive cervical carcinoma (pT1b-pT4a) and pelvic lymph nodes by high resolution MRI with a circularly polarized (cp) phased-array coil in correlation with the whole-mount specimen and the histopathological findings.


METHOD
Thirty-three patients (20-68 years old; mean age 55 years) with biopsy-proven primary cancer of the cervix were prospectively examined on a 1.5 T scanner by using a cp body phased-array coil. The MR protocol consisted of high resolution T2-weighted turbo-SE (TSE) and pre- and postcontrast T1-weighted SE (SE) sequences. Slice thickness was 5-7 mm with a pixel size of 0.3-0.4 mm2. All MRI findings were matched to the whole-mount specimens and the histopathological findings.


RESULTS
Pathological stages evaluated were pT1b (n = 5), pT2b (n = 16), and pT4a (n = 12). The overall accuracy rates for tumor staging were 79% for high resolution T2-weighted TSE and 76% for postcontrast T1-weighted SE images. The accuracy for high resolution T2-weighted TSE images in determining parametrial infiltration, pelvic side wall, and bladder and rectal wall infiltration was 84, 87, and 87%, respectively. In prospective analysis of the 1.0 cm criterion for diagnosis of a positive pelvic lymph node, MRI had a 72% accuracy, a 68% sensitivity, and a 78% specificity.


CONCLUSION
High resolution MRI with a cp body phased-array coil provides excellent and robust high resolution images in patients with invasive cervical carcinoma. However, accuracy, specificity, and sensitivity for staging invasive cervical carcinoma and pelvic lymph nodes with correlation to whole-mount specimens and histopathological findings did not improve compared with the results in the literature using a body coil with thicker slices and a lower spatial resolution.