Gennaro Restaino MD, Presenter: Nothing to Disclose

Mariavittoria Occhionero MD, Abstract Co-Author: Nothing to Disclose

Lorena Aquilani MD, Abstract Co-Author: Nothing to Disclose

Eleonora Cucci MD, Abstract Co-Author: Nothing to Disclose

Matteo Ciuffreda MD, Abstract Co-Author: Nothing to Disclose

Giuseppina Sallustio MD, Abstract Co-Author: Nothing to Disclose

To assess the accuracy of MRI in evaluating the locally advanced cervical cancer (LACC) response to concurrent preoperative chemoradiation therapy, using qualitative and dimensional and volumetric quantitative criteria

1.5 T pelvic MRI pre- and post chemoradiation therapy in 55 patients with LACC (53 y/o; 30-79) were retrospectevely qualitatively evaluated by two radiologists with 10 and 7 years of practice in gynecologic MRI for presence or absence of residual disease. The quantitative analysis included: tumor diameters, tumor volumes calculated with ellypsoid method and with 3-D volumetry according Simpson’s modified formula before and after treatment, and fractional regression rate. The MRI findings were correlated to histopathologic findings with Wilcoxon Signed-Rank test and with Mann-Whitney test.

Qualitative evaluation showed sensitivity, specificity, accuracy, positive predictive value, negative predictive value, LR+, and LR-: 93%, 53%, 63.6%, 42%, 96%, 1.965, and 0.127. Quantitative analysis showed that the diameter of residual disease measured by MRI was on average twice the true diameter measured at histology (18 mm versus 9 mm). No quantitative dimensional criterion showed significant differences between true positive and false positive cases.

Qualitative MRI has very high sensitivity and negative predictive value, but low specificity and positive predictive value for predicting presence of residual disease after chemoradiation treatment in LACC. Evaluation of quantitative dimensional parameters didn’t improve the accuracy of the technique and was of no help in differential diagnosis between true and false positives qualitative evaluations.

The very high sensitivity and negative predictive value of MRI for detection of residual cervical disease may help in discern women in which completion surgery is not indicated

Restaino, G, Occhionero, M, Aquilani, L, Cucci, E, Ciuffreda, M, Sallustio, G, Locally Advanced Cervical Cancer: MR Imaging in Prediction of Response after Preoperative Chemoradiation Therapy.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11005183.html