Negative MRI findings with invasive cervical biopsy may indicate stage IA cervical carcinoma

Objective. We attempted to prospectively determine the role of magnetic resonance imaging (MRI) in very early cervical cancer. Study design. T2-weighted and T1-dynamic enhanced images from patients with invasive or noninvasive lesions of the cervix were reviewed by two radiologists who had no clinical information on these patients. At least 12 longitudinal sections prepared from the surgically removed cervix were reviewed by a pathologist. The correlation between MRI and histological findings was analyzed in terms of depth of invasion. Results. Seventy-nine cases were entered into the study and 75 were evaluable. Accuracy of T2 MR images for invasive and noninvasive disease by Radiologist 1 and Radiologist 2 was 0.8533 and 0.7733, respectively. Accuracy was greater (0.9867 and 0.9467, respectively) for the detection of noninvasive plus microinvasive lesions >5 mm vs invasive lesions ≤5 mm. Dynamic technique provided only limited additional value in the detection of microinvasive cervical carcinoma. Conclusion. Simple T2 MRI is useful in differentiating noninvasive or microinvasive cervical lesions from invasive cervical carcinoma of the cervix >5 mm. (C) 2000 Academic Press.