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A study to evaluate preoperative imaging in patients diagnosed with early, invasive cervical cancer supported, in part, with funding from the National Cancer Institute, was recently published in the medical journal Radiology. Researchers concluded, after comparing scan findings from both MRI and CT that imaging for this disease requires advances in order to provide critical disease information procured with pathologic assessment.

The research team that published the findings, the American College of Radiology Imaging Network (ACRIN) and Gynecologic Oncology Group (GOG), examined a series of patients who had previously been recruited for participation in another study sponsored by the two cooperative groups. 152 patients took part in the effort; average age of participants was 43 years. All of the women had > IB stage disease.

The primary outcome of interest was the diagnostic performance of CT and MRI, comparing the two modalities, and interobserver variability in the interpretation of studies. Findings obtained from imaging were compared with the gold standard of disease assessment and staging, histopathologic evaluation of surgically obtained tissue. Four different radiologists reviewed the CTs and MRIs, respectively, for a total of eight reviewers.

CT had a higher rate of interobserver variability than did MRI. Agreement with respect to tumor visualization, detection of parametrial invasion, and stage of disease was also low for both as well. MRI, however, provided much improved visualization of the actual malignancy and detection of parametrial invasion.

The researchers detailed the sensitivity and specificity rates for each modality. Both CT and MRI had a high rate of specificity in the identification of advanced disease, but a low rate of specificity for such. MRI had a lower positive predictive value than CT; negative predictive values for the two were essentially equivalent.

November 28, 2007 Related topics: Imaging, Diagnostic, Radiology, Obstetrics, Gynecology & Neonatology