Loco-regional staging of cervical carcinoma: Is there a place for Multidetector CT?

Abstract

Objectives: Computer tomography (CT) is the most widely used diagnostic modality in the routine evaluation of distant metastatic disease. We aimed to evaluate the role of Multidetector CT (MDCT) in local staging of cervical malignancies. Patients and methods: In this prospective study 26 patients with pathologically proven cervical malignancies performed postcontrast MDCT of the abdomen and pelvis for local staging. Reconstruction of images was performed in the workstation. In a sample of 12 patients an extended study in which delayed images were obtained for more accurate ureteric evaluation. Data were analyzed using SPSS and McNemar test was used to calculate accuracy. Results: The overall accuracy of CT was 61.5% excluding the discrepancy in staging between CT and examination under anesthesia (EUA) due to distant metastases (three cases had distant metastases in CT which was not evaluated in EUA). This value was raised to 77% if vagina was assessed clinically rather than by CT. Conclusion: In cervical cancer; CT gave better results in staging of advanced cases than in early staged ones. Local staging was improved by acquisition of delayed scans.

Keywords

• Multidetector CT
• Cervical carcinoma
• Cancer staging
• Local staging