Role of imaging in pretreatment evaluation of early invasive cervical cancer: Results of the intergroup study American College of Radiology Imaging Network 6651-Gynecologic Oncology Group 183 Journal Article


Authors: Hricak, H.; Gatsonis, C.; Chi, D. S.; Amendola, M. A.; Brandt, K.; Schwartz, L. H.; Koelliker, S.; Siegelman, E. S.; Brown, J. J.; McGhee, R. B. Jr; Iyer, R.; Vitellas, K. M.; Snyder, B.; Long, H. J. 3rd; Fionca, J. V.; Mitchell, D. G.
Article Title: Role of imaging in pretreatment evaluation of early invasive cervical cancer: Results of the intergroup study American College of Radiology Imaging Network 6651-Gynecologic Oncology Group 183
Abstract: Purpose: To compare magnetic resonance imaging (MRI) and computed tomography (CT) with each other and to International Federation of Gynecology and Obstetrics (FIGO) clinical staging in the pretreatment evaluation of early invasive cervical cancer, using surgicopathologic findings as the reference standard. Patients and Methods: This prospective multicenter clinical study was conducted by the American College of Radiology Imaging Network and the Gynecologic Oncology Group from March 2000 to November 2002; 25 United States health centers enrolled 208 consecutive patients with biopsy-confirmed cervical cancer of FIGO stage ≥ IB who were scheduled for surgery based on clinical assessment. Patients underwent FIGO clinical staging, helical CT, and MRI. Surgicopathologic findings constituted the reference standard for statistical analysis. Results: Complete data were available for 172 patients; surgicopathologic findings were consistent with FIGO stages IA to IIA in 76% and stage ≥ IIB in 21%. For the detection of advanced stage (≥ NB), sensitivity was poor for FIGO clinical staging (29%), CT (42%), and MRI (53%); specificity was 99% for FIGO clinical staging, 82% for CT, and 74% for MRI; and negative predictive value was 84% for FIGO clinical staging, 84% for CT, and 85% for MRI. MRI (area under the receiver operating characteristic curve [AUC], 0.88) was significantly better than CT (AUC, 0.73) for detecting cervical tumors (P = .014). For 85% of patients, FIGO clinical staging forms were submitted after MRI and/or CT was performed. Conclusion: CT and MRI performed similarly; both had lower staging accuracy than in prior single-institution studies. Accuracy of FIGO clinical staging was higher than previously reported. The temporal data suggest that FIGO clinical staging was influenced by CT and MRI findings. © 2005 by American Society of Clinical Oncology.
Keywords: adult; controlled study; human tissue; aged; aged, 80 and over; middle aged; major clinical study; clinical trial; histopathology; squamous cell carcinoma; carcinoma, squamous cell; comparative study; cancer staging; nuclear magnetic resonance imaging; methodology; magnetic resonance imaging; neoplasm staging; diagnostic accuracy; preoperative evaluation; prospective study; sensitivity and specificity; prospective studies; adenocarcinoma; computer assisted tomography; controlled clinical trial; clinical assessment; tomography, x-ray computed; pathology; bladder tumor; cancer invasion; standard; early cancer; multicenter study; uterine cervix cancer; medical society; intermethod comparison; radiography; adenosquamous carcinoma; neoplasm invasiveness; uterine cervical neoplasms; rectum tumor; uterine cervix tumor; receiver operating characteristic; spiral computer assisted tomography; carcinoma, adenosquamous
Journal Title: Journal of Clinical Oncology
Volume: 23
Issue: 36
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2005-01-01
Start Page: 9329
End Page: 9337
Language: English
DOI: 10.1200/jco.2005.02.0354
PUBMED: 16361632
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 71" - "Export Date: 24 October 2012" - "CODEN: JCOND" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Dennis S Chi
    495 Chi
  2. Lawrence H Schwartz
    281 Schwartz
  3. Hedvig Hricak
    330 Hricak
  4. Rajiv Raman Iyer
    2 Iyer