Intravaginal contrastenhanced MR imaging in preoperative assessment of local extension of invasive cervical cancer

The study included 56 patients with stage IB1–IIIB (FIGO) invasive cervical cancer with tumor size of more than 2,0 cm. The patients did not receive neoadjuvant therapy before surgery. All patients underwent preoperative MRI including intravaginal contrast. Examination was performed using Titan Vintage MR-tomograph with magnetic field strength of 1,5 T (Toshiba MS). Starch solution was used for intracavitary contrast. MRI findings were compared with results of postoperative histological study. Diagnostic value of MRI in preoperative assessment of local extension of invasive cervical cancer using the standard technique was as follows: sensitivity, specificity and accuracy rates were 71 %, 75 % and 69 %. Positive predictive value (PPV) was 65 % and negative predictive value (NPV) was 80 %. The use of intravenous contrast for patients with exophytic cervical cancer contributed to the increase in sensitivity to 90 %, specificity to 84 %, accuracy to 82 %, PPV to 79 % and NPV to 90 %. The technique of intravaginal contrast with starch solution has a high diagnostic value in preoperative staging of invasive cervical cancer. It is easy to use technique requiring no significant additional financial costs and, therefore, it can be recommended to be applied in clinical settings.