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Cervical Carcinoma: Can Dynamic Contrast-enhanced MR Imaging Help Predict Tumor Aggressiveness?

¹ Departments of Radiology (S.P., P.M.T.P., C.S.P.v.R.)
² Gynecology (J.B.T.), Leiden University Medical Center, the Netherlands.

PURPOSE: To determine whether fast dynamic contrast agent–enhanced magnetic resonance (MR) imaging can demonstrate tumor aggressiveness of cervical carcinoma in patients who are eligible for surgical treatment.

MATERIALS AND METHODS: Dynamic contrast-enhanced MR imaging of cervical carcinoma was performed in 82 consecutive patients with stage I or IIA disease who were referred for radical hysterectomy. The maximum slope and amplitude of dynamic first-pass contrast enhancement were quantified. These parameters were correlated with histologic measures of tumor aggressiveness (tumor invasion depth, pelvic lymph node status).

RESULTS: The analysis was based on tumors in 62 patients: 30 aggressive and 32 relatively nonaggressive tumors. Twenty patients were excluded from analysis owing to insufficient surgical data, tumor too small for accurate assessment, or technical problems. There were no significant differences between aggressive and nonaggressive tumors in terms of the first-pass contrast-enhancement parameters of slope (2.0 vs 2.1 arbitrary signal intensity units per second, P > .5) or amplitude (24.8 vs 27.8 arbitrary units, P > .2).

CONCLUSION: Dynamic contrast-enhanced MR imaging does not facilitate differentiation between aggressive and nonaggressive tumors and therefore has no clinical role in assisting in treatment decisions in patients who are candidates for radical hysterectomy.

Index terms: Magnetic resonance (MR), treatment planning, 854.32, 854.33 • Uterine neoplasms, 854.32 • Uterine neoplasms, metastases, 992.33 • Uterus, MR, 854.121412, 854.12143

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