BACKGROUND

Accurate staging of cervical cancer via conventional magnetic resonance imaging (MRI) remains challenging, suggesting a greater need for coil placement closer to the region of interest. This study aimed to determine the value of 3.0-T MRI with an endovaginal coil combined with the pelvic array coil (combined coil) in the preoperative staging of cervical cancer and its correlation with histopathology.

METHODS

Patients with cervical cancer who received 3.0-T MR scans with the pelvic array coil and combined coil from January 2023 to March 2024 at The First Affiliated Hospital of Chongqing Medical University were included in the study. The accuracy of preoperative staging was compared between the two groups with surgical pathological staging as the gold standard, and image features such as parametrial involvement and vaginal invasion were analyzed.

RESULTS

The voxel size value for the pelvic coil was 1.83 (0.78×0.78×3) mm, and that of the combined coil was 0.44 (0.47×0.47×2) mm. The accuracy of combined coil staging was higher than that of the pelvic array coil (85.0% 72.5%). The sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of the pelvic array coil in diagnosing parametrial involvement was 71.4%, 90.9%, 87.5%, 62.5% and 93.7%, respectively; meanwhile, for diagnosing vaginal invasion, they were 86.4%, 88.9%, 87.5%, 90.5%, and 84.2%, respectively. For the combined coil, the sensitivity, specificity, accuracy, PPV, and NPV in diagnosing parametrial involvement were 85.7%, 97.0%, 95.0%, 85.7%, and 97.0%, respectively; meanwhile, for diagnosing vaginal invasion, they were 95.5%, 94.4%, 95.0%, 95.5%, and 94.4%, respectively. The combined coil showed a high consistency with postoperative pathology in diagnosing parametrial involvement (κ=0.827) and vaginal invasion (κ=0.899), indicating that the combined coil had superior staging accuracy than did the pelvic array coil.

CONCLUSIONS

The endovaginal coil can improve the high-resolution images of the cervical region while visualizing the lesion size and extent, along with the depth of infiltration of the surrounding tissues. The 3.0-T MRI with an endovaginal coil combined with a pelvic array coil has a high application value in the preoperative staging of cervical cancer. It can also provide an important basis for clinical decision-making.