Recurrent carcinoma of the cervix: CT diagnosis

Thirty-three patients with previously treated carcinoma of the cervix were evaluated with computed tomography (CT) for recurrent tumor. Recurrent carcinoma was confirmed in 29 patients and radiation sequelae were documented in four patients. CT diagnosis was true positive for recurrence in 82%, false negative in 6%, false positive in 6%, and equivocal in 6%. False-negative examinations were due to small, superficial, clinically detectable tumor foci in the vagina or perineum. False-positive and equivocal examinations were due to radiation changes in the true pelvis. CT was valuable in assessing central pelvic tumor recurrence, parametrial and sidewall tumor extension, pelvic and paraaortic lymphadenopathy, and the obstruction site of hydronephrosis. Since CT detected recurrent tumor in 27 of 29 patients (sensitivity 93%), it is a valuable noninvasive technique to screen patients with suspected recurrent tumor and to evaluate those with known recurrence for disease extent and subsequent therapy.