Sergey Sedykh MD, Abstract Co-Author: Nothing to Disclose

Natalia Rubtsova, Presenter: Nothing to Disclose

Elena Grigorevna Novikova MD, Abstract Co-Author: Nothing to Disclose

Vitaly Antipov MD, Abstract Co-Author: Nothing to Disclose

The aim was: 1) To compare the preoperative findings of magnetic resonance imaging (MRI) with clinical staging (FIGO) and postoperative pathology reports in patients with early invasive cervical cancer. 2) To study the frequency of recurrent tumour after radical abdominal trachelectomy.

This clinical study was conducted by the Moscow Herzen Research Cancer Institute from May 2006 to April 2008. For preserving the patient’s fertility, 35 women with stage IA1 – IB1 (FIGO) cervical carcinoma were offered abdominal radical trachelectomy (ART). Patient ranged in age from 22 to 39 years with a mean age of 30.9. Principal eligibility criteria for selecting patients for ART were: squamous cell carcinoma or adenocarcinoma histological subtypes; FIGO stage IA1 with the presence of lymph-vascular space invasion or IA2-IB1; lesion size < or = 2cm;  no involvement of the upper cervical canal; no metastases to regional lymph nodes. All women underwent MRI of the pelvis, before and at least twice a year after ART. The relationship between MRI and pathological findings was also evaluated. MR imaging was performed at 1.5 T (GE Signa) using a flexible 4 channel torso coil. T2-weighted frFSE images were acquired in transaxial and sagittal plans. T2-weighted FSE images were obtained in oblique plans (before treatment parallel and perpendicular to the main axis of the endocervical canal and after ART parallel and perpendicular to the anastomosis between uterine corpus and vagina; the section thickness was 3mm). 

Cervical cancer with stromal invasion larger then 5 mm was well revealed.  The most of difficulties of imaging were caused by inflammation. The sensitivity, specificity and accuracy of MRI for overall tumour staging of early invasive cervical cancer (including detection of lymhp node metastases) were 78.3%, 89.6% and 79.6% respectively. During the post-operative monitoring in 2 (5.7%) of 35 cases were determined recurrent tumour, and in 1 (2.9%) case MRI detected ovarian metastases, these finds were verified by histological data.

This study prove that MRI can be recommended for planning a fertility-preserving alternative treatment of cervical cancer such as trachelectomy. MRI is an optimal method for patient observation after ART.

MRI can be used as valuable adjuncts to planning trachelectomy as treatment of early invasive cervical cancer in young patients.

Sedykh, S, Rubtsova, N, Novikova, E, Antipov, V, Role of MRI in Selecting Patient for Radical Abdominal Trachelectomy: Postoperative Monitoring.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6008011.html