Ditto Antonino, Leone Roberti Maggiore Umberto, Evangelisti Giulio, Bogani Giorgio, Chiappa Valentina, Martinelli Fabio, Raspagliesi Francesco
Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy.
Academic Unit of Obstetrics and Gynaecology, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy.
Cancers (Basel). 2023 Mar 30;15(7):2061. doi: 10.3390/cancers15072061.
Magnetic resonance imaging (MRI) has been proven to ensure high diagnostic accuracy in the identification of vaginal, parametrial, and lymph node involvement in patients affected by cervical cancer (CC), thus playing a crucial role in the preoperative staging of the disease. This study aims to compare the accuracy of MRI for the preoperative staging of patients with CC who underwent neoadjuvant treatment (NAT) or direct surgery. Retrospective data analysis of 126 patients with primary CC International Federation of Gynecology and Obstetrics stage IB3-IIB who underwent NAT before radical surgery (NAT group = 94) or received surgical treatment alone (control arm = 32) was prospectively performed. All enrolled patients were clinically assessed with both a pelvic examination and MRI before surgical treatment. Data from the clinical examination were compared with the histopathological findings to assess the accuracy of MRI for staging purposes after NAT or before direct surgery. MRI showed an overall accuracy of 46.1%, proving it to be not superior to pelvic and physical examination. The overall MRI accuracy for the evaluation of parametrial, vaginal, and lymph node status was 65.8%, 79.4%, and 79.4%, respectively. In the NAT group, the accuracy for the detection of parametrial, lymph node, and vaginal involvement was lower than the control group; however, the difference was not significant ( ≥ 0.05). The overall accuracy of MRI for the preoperative staging of CC after NAT is shown to be not unsatisfactory. The limits of MRI staging are especially evident when dealing with pre-treated patients.
磁共振成像（MRI）已被证明在识别宫颈癌（CC）患者的阴道、宫旁组织和淋巴结受累情况方面具有很高的诊断准确性，因此在该疾病的术前分期中发挥着关键作用。本研究旨在比较MRI对接受新辅助治疗（NAT）或直接手术的CC患者进行术前分期的准确性。对126例国际妇产科联盟分期为IB3-IIB期的原发性CC患者进行了回顾性数据分析，这些患者在根治性手术前接受了NAT（NAT组=94）或仅接受了手术治疗（对照组=32）。所有纳入的患者在手术治疗前均接受了盆腔检查和MRI的临床评估。将临床检查数据与组织病理学结果进行比较，以评估NAT后或直接手术前MRI用于分期的准确性。MRI的总体准确率为46.1%，证明其并不优于盆腔检查和体格检查。MRI评估宫旁组织、阴道和淋巴结状态的总体准确率分别为65.8%、79.4%和79.4%。在NAT组中，检测宫旁组织、淋巴结和阴道受累的准确率低于对照组；然而，差异不显著（≥0.05）。NAT后MRI对CC术前分期的总体准确率显示并不理想。在处理经过预处理的患者时，MRI分期的局限性尤为明显。
