Computed tomography in staging untreated patients with cervical cancer

In a study to test the accuracy of computed tomography (CT) in staging untreated patients with cervical cancer, the interpretations of the CT scans of pelvis and abdomen of 56 consecutive patients were compared with surgical and/or clinical findings. This study clearly demonstrates that CT is unreliable in diagnosing parametrial tumour invasion and that it is not justified to make the therapeutically important differentiation between a IB or IIB stage with CT. In demonstrating metastatic lymph nodes, the accuracy of CT was only 75%, predominantly due to metastatic deposits in normal-sized nodes. CT was less accurate in diagnosing bladder wall and sigmoid invasion than cystoscopy and sigmoidoscopy, respectively, and was as accurate as urography in diagnosing ureteric obstruction. For these reasons, CT is not indicated as a routine procedure in cervical cancer staging, particularly not in the early stages of the disease. CT may be helpful in the higher clinical stages to measure tumour bulk and to get an impression about the whole extent of the disease.