Accuracy of Multiplanar MR Images in Determination of Actual Tumour Size in Comparison to the Pelvic Examination of Carcinoma Cervix

Husnaion Zubery; Mahbuba Shirin; Falguni Binte Rahman; Biswajit Bhowmik; Mohammad Ibrahim; Zakia Sultana

doi:doi:10.11648/j.ijcocr.20210603.16

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Accuracy of Multiplanar MR Images in Determination of Actual Tumour Size in Comparison to the Pelvic Examination of Carcinoma Cervix

Husnaion Zubery, Mahbuba Shirin, Falguni Binte Rahman, Biswajit Bhowmik, Mohammad Ibrahim, Zakia Sultana

Published in International Journal of Clinical Oncology and Cancer Research (Volume 6, Issue 3)

Received: 7 July 2021 Accepted: 24 July 2021 Published: 2 August 2021

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Abstract

Accurate staging of patients with cervical carcinoma is crucial for appropriate management planning and tumor size has consistently been a key component & major determinant when deciding management plan in especially with early-stages as it dictates whether a patient is a candidate for conservative surgery, radical hysterectomy or chemoradiation. Tumor size also provides a prognostic value, as larger tumors predict risk for distant spread of disease and poor prognostic outcomes. The objective of this study was to determine the sensitivity and specificity of Magnetic Resonance Imaging in the measurement of actual tumor size of invasive cervical carcinoma in comparison to pelvic examination taking histopathology as gold standard. This prospective cross sectional study was conducted in the Department of Radiology and Imaging, BSMMU, Dhaka during the period of September 2018 to August 2020. A total of 60 patients were selected purposively and all were undergone pelvic examination clinically by EUA. Then all of them underwent MRI in Department of Radiology and Imaging, BSMMU. Images of uterine cervix, corpus, vagina and parametrium are taken with a prefixed standard protocol and reporting was done by Radiologist. Comparison was done between the MRI and clinical assessment of actual tumour size. Out of 60 patients in this study the mean age was found 47.5±10.1 years with range from 22 to 60 years. Positive correlation (r=0.993; p=0.001) between histopathological size and MRI size of tumour. Positive correlation (r=0.950; p=0.001) between histopathological size and FIGO size of tumour. MRI findings more correlates with histopathology than clinically detected tumor size. Based on pathologic findings, accuracy was estimated by the degree of agreement with a difference of <0.5 or 1.0 cm between the measurements of tumor size obtained by pelvic examination and imaging modality. Pelvic examination and imaging modality had an accuracy of 53.3% and 75%, respectively, with a difference of <0.5 cm, and an accuracy of 88.3% and 100%, respectively, with a difference of 0.5-1.0 cm. The study also concluded MRI staging was more concordant with pathological stage compared to the clinical stage. Concordance rate of 95.0% in MRI and 65.0% in clinical staging respectively. FIGO staging concurred with histopathology in 39 (65.0%) cases and differed in 21 (35.0%) cases. Magnetic resonance imaging (MRI) is a sensitive and specific modality for accurate determination of tumour size as well as staging of cervical carcinoma in comparison to pelvic examination taking histopathology as gold standard.

Published in	International Journal of Clinical Oncology and Cancer Research (Volume 6, Issue 3)
DOI	10.11648/j.ijcocr.20210603.16
Page(s)	136-140
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Cervical Carcinoma, MRI, FIGO, Histopathology

References

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[2]	Stenstedt K, Hellström AC, Fridsten S, Blomqvist L. Impact of MRI in the management and staging of cancer of the uterine cervix. Acta oncologica. 2011 Apr 1; 50 (3): 420-6.
[3]	Kumari, D. A. and Paga, A., 2017. “Comparative study of MRI staging Vs FIGO staging of carcinoma cervix.” International journal of contemporary medical research, 4 (5), pp. 1196- 1198.
[4]	Kirova G, Nedialkov K, Sergieva S. Magnetic resonance imaging and its value in the staging of cervical carcinoma-Comparison of magnetic resonance imaging and pathological images with FIGO staging system. JOURNAL-BALKAN UNION OF ONCOLOGY. 2004 Apr 1; 9: 127-38.
[5]	Sauer J, Simonds HM, Van der Merwe H, Hattingh SM. A retrospective analysis comparing clinical staging with magnetic resonance imaging staging in patients with cervical cancer. Southern African Journal of Gynaecological Oncology. 2013 Jan 1; 5 (1): 11-5.
[6]	Lee YK, Han SS, Kim JW, Park NH, Song YS, Kang SB. Value of pelvic examination and imaging modality for the evaluation of tumor size in cervical cancer. Journal of gynecologic oncology. 2008 Jun; 19 (2): 108.
[7]	Zaino RJ, Ward S, Delgado G, Bundy B, Gore H, Fetter G, Ganjei P, Frauenhofer E. Histopathologic predictors of the behavior of surgically treated stage IB squamous cell carcinoma of the cervix a gynecologic oncology group study. Cancer. 1992 Apr 1; 69 (7): 1750-8.
[8]	Vinh-Hung V, Bourgain C, Vlastos G, Cserni G, De Ridder M, Storme G, Vlastos AT. Prognostic value of histopathology and trends in cervical cancer: a SEER population study. BMC cancer. 2007 Dec; 7 (1): 1-3.
[9]	Metindir J, Bilir G. Prognostic factors affecting disease-free survival in early-stage cervical cancer patients undergoing radical hysterectomy and pelvic-paraaortic lymphadenectomy. European journal of gynaecological oncology. 2007 Jan 1; 28 (1): 28-32.
[10]	Chung CK, Nahhas WA, Stryker JA, Curry SL, Abt AB, Mortel R. Analysis of factors contributing to treatment failures in stages IB and IIA carcinoma of the cervix. American Journal of Obstetrics and Gynecology. 1980 Nov 1; 138 (5): 550-6.
[11]	Homesley HD, Raben M, Blake DD, Ferree CR, Bullock MS, Linton EB, Greiss Jr FC, Rhyne AL. Relationship of lesion size to survival in patients with stage IB squamous cell carcinoma of the cervix uteri treated by radiation therapy. Surgery, gynecology & obstetrics. 1980 Apr 1; 150 (4): 529-31.
[12]	Kristensen GB, Abeler VM, Risberg B, Tropé C, Bryne M. Tumor size, depth of invasion, and grading of the invasive tumor front are the main prognostic factors in early squamous cell cervical carcinoma. Gynecologic oncology. 1999 Aug 1; 74 (2): 245-51.
[13]	Trattner M, Graf AH, Lax S, Forstner R, Dandachi N, Haas J, Pickel H, Reich O, Staudach A, Winter R. Prognostic factors in surgically treated stage Ib–IIb cervical carcinomas with special emphasis on the importance of tumor volume. Gynecologic oncology. 2001 Jul 1; 82 (1): 11-6.
[14]	Horn LC, Fischer U, Raptis G, Bilek K, Hentschel B. Tumor size is of prognostic value in surgically treated FIGO stage II cervical cancer. Gynecologic oncology. 2007 Nov 1; 107 (2): 310-5.
[15]	Nicolet V, Carignan L, Bourdon F, Prosmanne O. MR imaging of cervical carcinoma: a practical staging approach. Radiographics. 2000 Nov; 20 (6): 1539-49.

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Husnaion Zubery, Mahbuba Shirin, Falguni Binte Rahman, Biswajit Bhowmik, Mohammad Ibrahim, et al. (2021). Accuracy of Multiplanar MR Images in Determination of Actual Tumour Size in Comparison to the Pelvic Examination of Carcinoma Cervix. International Journal of Clinical Oncology and Cancer Research, 6(3), 136-140. https://doi.org/10.11648/j.ijcocr.20210603.16

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ACS Style

Husnaion Zubery; Mahbuba Shirin; Falguni Binte Rahman; Biswajit Bhowmik; Mohammad Ibrahim, et al. Accuracy of Multiplanar MR Images in Determination of Actual Tumour Size in Comparison to the Pelvic Examination of Carcinoma Cervix. Int. J. Clin. Oncol. Cancer Res. 2021, 6(3), 136-140. doi: 10.11648/j.ijcocr.20210603.16

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AMA Style

Husnaion Zubery, Mahbuba Shirin, Falguni Binte Rahman, Biswajit Bhowmik, Mohammad Ibrahim, et al. Accuracy of Multiplanar MR Images in Determination of Actual Tumour Size in Comparison to the Pelvic Examination of Carcinoma Cervix. Int J Clin Oncol Cancer Res. 2021;6(3):136-140. doi: 10.11648/j.ijcocr.20210603.16

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@article{10.11648/j.ijcocr.20210603.16,
  author = {Husnaion Zubery and Mahbuba Shirin and Falguni Binte Rahman and Biswajit Bhowmik and Mohammad Ibrahim and Zakia Sultana},
  title = {Accuracy of Multiplanar MR Images in Determination of Actual Tumour Size in Comparison to the Pelvic Examination of Carcinoma Cervix},
  journal = {International Journal of Clinical Oncology and Cancer Research},
  volume = {6},
  number = {3},
  pages = {136-140},
  doi = {10.11648/j.ijcocr.20210603.16},
  url = {https://doi.org/10.11648/j.ijcocr.20210603.16},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcocr.20210603.16},
  abstract = {Accurate staging of patients with cervical carcinoma is crucial for appropriate management planning and tumor size has consistently been a key component & major determinant when deciding management plan in especially with early-stages as it dictates whether a patient is a candidate for conservative surgery, radical hysterectomy or chemoradiation. Tumor size also provides a prognostic value, as larger tumors predict risk for distant spread of disease and poor prognostic outcomes. The objective of this study was to determine the sensitivity and specificity of Magnetic Resonance Imaging in the measurement of actual tumor size of invasive cervical carcinoma in comparison to pelvic examination taking histopathology as gold standard. This prospective cross sectional study was conducted in the Department of Radiology and Imaging, BSMMU, Dhaka during the period of September 2018 to August 2020. A total of 60 patients were selected purposively and all were undergone pelvic examination clinically by EUA. Then all of them underwent MRI in Department of Radiology and Imaging, BSMMU. Images of uterine cervix, corpus, vagina and parametrium are taken with a prefixed standard protocol and reporting was done by Radiologist. Comparison was done between the MRI and clinical assessment of actual tumour size. Out of 60 patients in this study the mean age was found 47.5±10.1 years with range from 22 to 60 years. Positive correlation (r=0.993; p=0.001) between histopathological size and MRI size of tumour. Positive correlation (r=0.950; p=0.001) between histopathological size and FIGO size of tumour. MRI findings more correlates with histopathology than clinically detected tumor size. Based on pathologic findings, accuracy was estimated by the degree of agreement with a difference of <0.5 or 1.0 cm between the measurements of tumor size obtained by pelvic examination and imaging modality. Pelvic examination and imaging modality had an accuracy of 53.3% and 75%, respectively, with a difference of <0.5 cm, and an accuracy of 88.3% and 100%, respectively, with a difference of 0.5-1.0 cm. The study also concluded MRI staging was more concordant with pathological stage compared to the clinical stage. Concordance rate of 95.0% in MRI and 65.0% in clinical staging respectively. FIGO staging concurred with histopathology in 39 (65.0%) cases and differed in 21 (35.0%) cases. Magnetic resonance imaging (MRI) is a sensitive and specific modality for accurate determination of tumour size as well as staging of cervical carcinoma in comparison to pelvic examination taking histopathology as gold standard.},
 year = {2021}
}

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TY - JOUR
T1 - Accuracy of Multiplanar MR Images in Determination of Actual Tumour Size in Comparison to the Pelvic Examination of Carcinoma Cervix
AU - Husnaion Zubery
AU - Mahbuba Shirin
AU - Falguni Binte Rahman
AU - Biswajit Bhowmik
AU - Mohammad Ibrahim
AU - Zakia Sultana
Y1 - 2021/08/02
PY - 2021
N1 - https://doi.org/10.11648/j.ijcocr.20210603.16
DO - 10.11648/j.ijcocr.20210603.16
T2 - International Journal of Clinical Oncology and Cancer Research
JF - International Journal of Clinical Oncology and Cancer Research
JO - International Journal of Clinical Oncology and Cancer Research
SP - 136
EP - 140
PB - Science Publishing Group
SN - 2578-9511
UR - https://doi.org/10.11648/j.ijcocr.20210603.16
AB - Accurate staging of patients with cervical carcinoma is crucial for appropriate management planning and tumor size has consistently been a key component & major determinant when deciding management plan in especially with early-stages as it dictates whether a patient is a candidate for conservative surgery, radical hysterectomy or chemoradiation. Tumor size also provides a prognostic value, as larger tumors predict risk for distant spread of disease and poor prognostic outcomes. The objective of this study was to determine the sensitivity and specificity of Magnetic Resonance Imaging in the measurement of actual tumor size of invasive cervical carcinoma in comparison to pelvic examination taking histopathology as gold standard. This prospective cross sectional study was conducted in the Department of Radiology and Imaging, BSMMU, Dhaka during the period of September 2018 to August 2020. A total of 60 patients were selected purposively and all were undergone pelvic examination clinically by EUA. Then all of them underwent MRI in Department of Radiology and Imaging, BSMMU. Images of uterine cervix, corpus, vagina and parametrium are taken with a prefixed standard protocol and reporting was done by Radiologist. Comparison was done between the MRI and clinical assessment of actual tumour size. Out of 60 patients in this study the mean age was found 47.5±10.1 years with range from 22 to 60 years. Positive correlation (r=0.993; p=0.001) between histopathological size and MRI size of tumour. Positive correlation (r=0.950; p=0.001) between histopathological size and FIGO size of tumour. MRI findings more correlates with histopathology than clinically detected tumor size. Based on pathologic findings, accuracy was estimated by the degree of agreement with a difference of <0.5 or 1.0 cm between the measurements of tumor size obtained by pelvic examination and imaging modality. Pelvic examination and imaging modality had an accuracy of 53.3% and 75%, respectively, with a difference of <0.5 cm, and an accuracy of 88.3% and 100%, respectively, with a difference of 0.5-1.0 cm. The study also concluded MRI staging was more concordant with pathological stage compared to the clinical stage. Concordance rate of 95.0% in MRI and 65.0% in clinical staging respectively. FIGO staging concurred with histopathology in 39 (65.0%) cases and differed in 21 (35.0%) cases. Magnetic resonance imaging (MRI) is a sensitive and specific modality for accurate determination of tumour size as well as staging of cervical carcinoma in comparison to pelvic examination taking histopathology as gold standard.
VL - 6
IS - 3
ER -

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Author Information

Husnaion Zubery

Department of Radiology and Imaging, Rajshahi Medical College Hospital, Rajshahi, Bangladesh
Mahbuba Shirin

Department of Radiology and Imaging, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
Falguni Binte Rahman

Department of Pharmacology and Therapeutics, Rajshahi Medical College, Rajshahi, Bangladesh
Biswajit Bhowmik

Department of Radiology and Imaging, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
Mohammad Ibrahim

Directorate General of Health Services, Dhaka, Bangladesh
Zakia Sultana

Directorate General of Health Services, Dhaka, Bangladesh

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APA Style

Husnaion Zubery, Mahbuba Shirin, Falguni Binte Rahman, Biswajit Bhowmik, Mohammad Ibrahim, et al. (2021). Accuracy of Multiplanar MR Images in Determination of Actual Tumour Size in Comparison to the Pelvic Examination of Carcinoma Cervix. International Journal of Clinical Oncology and Cancer Research, 6(3), 136-140. https://doi.org/10.11648/j.ijcocr.20210603.16

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ACS Style

Husnaion Zubery; Mahbuba Shirin; Falguni Binte Rahman; Biswajit Bhowmik; Mohammad Ibrahim, et al. Accuracy of Multiplanar MR Images in Determination of Actual Tumour Size in Comparison to the Pelvic Examination of Carcinoma Cervix. Int. J. Clin. Oncol. Cancer Res. 2021, 6(3), 136-140. doi: 10.11648/j.ijcocr.20210603.16

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AMA Style

Husnaion Zubery, Mahbuba Shirin, Falguni Binte Rahman, Biswajit Bhowmik, Mohammad Ibrahim, et al. Accuracy of Multiplanar MR Images in Determination of Actual Tumour Size in Comparison to the Pelvic Examination of Carcinoma Cervix. Int J Clin Oncol Cancer Res. 2021;6(3):136-140. doi: 10.11648/j.ijcocr.20210603.16

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@article{10.11648/j.ijcocr.20210603.16,
  author = {Husnaion Zubery and Mahbuba Shirin and Falguni Binte Rahman and Biswajit Bhowmik and Mohammad Ibrahim and Zakia Sultana},
  title = {Accuracy of Multiplanar MR Images in Determination of Actual Tumour Size in Comparison to the Pelvic Examination of Carcinoma Cervix},
  journal = {International Journal of Clinical Oncology and Cancer Research},
  volume = {6},
  number = {3},
  pages = {136-140},
  doi = {10.11648/j.ijcocr.20210603.16},
  url = {https://doi.org/10.11648/j.ijcocr.20210603.16},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcocr.20210603.16},
  abstract = {Accurate staging of patients with cervical carcinoma is crucial for appropriate management planning and tumor size has consistently been a key component & major determinant when deciding management plan in especially with early-stages as it dictates whether a patient is a candidate for conservative surgery, radical hysterectomy or chemoradiation. Tumor size also provides a prognostic value, as larger tumors predict risk for distant spread of disease and poor prognostic outcomes. The objective of this study was to determine the sensitivity and specificity of Magnetic Resonance Imaging in the measurement of actual tumor size of invasive cervical carcinoma in comparison to pelvic examination taking histopathology as gold standard. This prospective cross sectional study was conducted in the Department of Radiology and Imaging, BSMMU, Dhaka during the period of September 2018 to August 2020. A total of 60 patients were selected purposively and all were undergone pelvic examination clinically by EUA. Then all of them underwent MRI in Department of Radiology and Imaging, BSMMU. Images of uterine cervix, corpus, vagina and parametrium are taken with a prefixed standard protocol and reporting was done by Radiologist. Comparison was done between the MRI and clinical assessment of actual tumour size. Out of 60 patients in this study the mean age was found 47.5±10.1 years with range from 22 to 60 years. Positive correlation (r=0.993; p=0.001) between histopathological size and MRI size of tumour. Positive correlation (r=0.950; p=0.001) between histopathological size and FIGO size of tumour. MRI findings more correlates with histopathology than clinically detected tumor size. Based on pathologic findings, accuracy was estimated by the degree of agreement with a difference of <0.5 or 1.0 cm between the measurements of tumor size obtained by pelvic examination and imaging modality. Pelvic examination and imaging modality had an accuracy of 53.3% and 75%, respectively, with a difference of <0.5 cm, and an accuracy of 88.3% and 100%, respectively, with a difference of 0.5-1.0 cm. The study also concluded MRI staging was more concordant with pathological stage compared to the clinical stage. Concordance rate of 95.0% in MRI and 65.0% in clinical staging respectively. FIGO staging concurred with histopathology in 39 (65.0%) cases and differed in 21 (35.0%) cases. Magnetic resonance imaging (MRI) is a sensitive and specific modality for accurate determination of tumour size as well as staging of cervical carcinoma in comparison to pelvic examination taking histopathology as gold standard.},
 year = {2021}
}

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