Cervical Cancer Staging in Saudi Arabia Clinicoradiological Correlation

The aim of this study was to compare the finding of pelvic MRI with clinical staging using cystoscopy and sigmoidoscopy for cervical cancer patients.

We reviewed all patients with cervical cancer between January 2001 and December 2015. We correlate the clinical examination, cystoscopy, and sigmoidoscopy with MRI findings.

A total of 152 patients were enrolled. 114 (74.9%) were with locally advanced cervix cancer. The true positives for MRI in the detection of parametrium were in 94 patients, with sensitivity, specificity, positive, PPV, and NPV of 72%, 82%, 96%, and 33%, respectively. The false negative of the MRI to detect the bladder invasion was 2. Nineteen patients reported having bladder invasion on MRI not confirmed by cystoscopy. None of the patients who had a negative rectal invasion by MRI were found to have rectal involvement by sigmoidoscopy with a specificity of 91%.

The combined MRI and clinical staging for parametrial evaluation should still be carried out for the staging of cervical cancer. However, in the absence of the bladder and the rectal invasion in the MRI, it will be safe to avoid the need for a cystoscopy and/or sigmoidoscopy for complete staging in the majority of patients with cervical cancer.