ROLE OF MAGNETIC RESONANCE IMAGING IN THE STAGING OF CERVICAL CANCER

Karcinom cerviksa uterusa je najčešći genitalni tumor u žena u nerazvijenim zemljama. Prognoza karcinoma cerviksa ovisi o stadiju bolesti, statusu limfnih čvorova, volumenu i dubini invazije tumora. Najčešće korišten sustav procjene proširenosti karcinoma cerviksa je onaj kojeg je usvojila Međunarodna federacija ginekologa i porodničara (FIGO). On se temelji isključivo na kliničkoj procjeni uključujući: fizikalni pregled, biopsiju sumnjivih lezija, RTG grudnih organa, cistoskopiju i rektoskopiju. Danas se sve više upotrebljavaju slikovne dijagnostičke metode, a najpoželjnija metoda je magnetska rezonancija. MR se opisuje kao najtočnija neinvazivna slikovna metoda u procjeni proširenosti karcinoma cerviksa. Ovim istraživanjem, koje je uključilo 31 bolesnicu i ukupno 47 nalaza MR, željela se prikazati uloga magnetske rezonancije u procjeni proširenosti karcinoma cerviksa kod bolesnica prije i nakon primijenjene terapije. Uz svaki MR analizirala se klinička slika i ginekološki nalaz koji su prethodili MR-u te odgovarajući terapijski pristup koji je uslijedio. Samo 8 bolesnica je liječeno kirurški dok su ostale liječene kemoradioterapijom. MR je utjecala na terapiju u 27% slučajeva i bolje je korelirala s patohistološkim nalazom nego klinička procjena. Većina bolesnica je bila u uznapredovalom stadiju što je utjecalo na rezultate istraživanja. Možemo zaključiti kako je uloga MR u procjeni proširenosti karcinoma cerviksa nadopuna kliničkom pregledu te, iako ga ne može zamijeniti, može utjecati na odluke o vrsti liječenja i može dati klinički važne prognostičke informacije.Cervical cancer is the most common genital malignancy among women in the developing countries. The prognosis of cervical cancer is determined by stage, nodal status, tumor volume, and depth of invasion. The most widely used staging system for cervical cancer is system developed by the International Federation of Gynecologic Oncology (FIGO). It is based only on clinical assessment which includes: physical examination, lesion biopsies, chest radiography, cystoscopy, and rectoscopy. Currently, there is an increased use of imaging modalities and the preferred imaging method for local cervical cancer evaluation is magnetic resonance imaging. MRI has been described as the most accurate, noninvasive imaging modality in staging of cervical carcinoma. With this study which included 31 patients and total of 47 MRI findings we aimed to assess the role of magnetic resonance imaging in the staging of cervical cancer in pretreatment and posttreatment patients. With each MRI finding, physical examination and treatment options were analyzed. Only 8 patients underwent surgery while the rest were treated with chemoradiotherapy. MRI had an impact on the treatment in 27% of the cases and had a better concordance with pathological staging. Most of the patients were in advanced stages of the disease which affected the results. In conclusion, the role of MRI in the staging of cervical cancer is a complementary method to the clinical assessment and it can’t replace it. However, it can influence the treatment options and give important clinical prognostic information