Use of transrectal ultrasound and magnetic resonance imaging in the staging of early-stage cervical cancer

Czech version

Authors: D. Fischerová ¹; D. Cibula ¹; H. Štěňhová ²; H. Vondřichová ²; M. Zikán ¹; P. Freitag ¹; J. Sláma ¹; D. Pavlišta ¹; I. Pinkavová ¹; P. Dundr ³
Authors‘ workplace: Onkogynekologické centrum, Gynekologicko-porodnická klinika VFN a 1. LF UK, Praha, přednosta prof. MUDr. A. Martan, DrSc. ¹; Diagnostické centrum Mediscan, vedoucí lékařka magnetické rezonance MUDr. H. Štěňhová ²; Ústav patologie VFN a 1. LF UK, Praha, přednosta prof. MUDr. C. Povýšil, DrSc. ³
Published in: Ceska Gynekol 2009; 74(5): 323-329

Overview

Objective:
The goal of this study was to compare the accuracy of magnetic resonance imaging (MRI) - a standard method - and transrectal ultrasound (TRUS) in the staging and determination of significant prognostic parameters in early-stage cervical cancer. The following prognostic parameters were evaluated: identification of residual tumor in the cervix after cone-biopsy, tumor volume, and early parametrial infiltration.

Design:
Prospective study.

Setting:
Oncogynecological Center, Department of Obstetrics and Gynecology, General Faculty Hospital of Charles University, Prague.

Methods:
Patients referred to Oncogynecological Center from January 2004 to February 2006, in whom early-stage cervical cancer (T1a1-T2a) was diagnosed by clinical examination, were prospectivelly enrolled in the study. Only those patients who were examined by both MRI and TRUS with following surgical treatment were included. Imaging results were compared with pathology findings.

Results:
Data from 95 patients were evaluated. The accuracy of tumor detection in 95 patients was 93.7% for TRUS and 83.2% for MRI (P ≤ 0.006). In small tumors (≤ 1cm³), the accuracy of tumor detection by TRUS was 90.5% and 81.1% by MRI (P≤0.049). The accuracy of parametrial infiltration detection by TRUS and MRI was 98.9% and 94.7%, respectively (P ≤ 0.219). The accuracy was not influenced by body mass index values.

Conclusion:
Our results show TRUS achieving comparable or even higher accuracy than the more commonly used MRI in staging of early-stage cervical cancer.

Key words:
cervical cancer, MRI, staging, transrectal ultrasound

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