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Abstract
Introduction/Background FIGO staging for cervical cancer was revised in 2018 by including imaging and pathological findings, to assign the stage and planning treatment. Now it is a routine practice to do MRI for early cervical cancer.
Methodology The aim of our study was to assess the sensitivity, specificity and diagnostic accuracy of MRI and clinical examination as compared to the final histopathology.
Design- Retrospective cohort study
The medical records of 88 patients who underwent radical hysterectomy for early invasive cervical cancer from January 2008 to December 2018 were reviewed. The clinical and radiological details including stage, size of the tumor, vaginal involvement, parametrial involvement were noted. This was compared with the final histopathology.
Diagnostic accuracy of Clinical Examination and MRI imaging with histopathology as gold standard was done by estimating the Sensitivity, specificity, positive predictive value, Negative Predictive value
Spearman’s Rho and Kendall’s tau equations were used to assess the correlation .
Results For tumors less than 2 cm, clinical examination & MRI had a comparable diagnostic accuracy of 77.8 & 73.1.For detecting parametrial involvement, clinical examination had 98.8% specificity, with NPV (negative predictive value) of 97.7,a diagnostic accuracy of 96.6 similar to MRI that was 96.5% specificity, NPV 97.64% and a diagnostic accuracy of 94.3.
For detecting vaginal involvement, both clinical examination and MRI had a NPV of 86.75% and a diagnostic accuracy of 84.1.For lymph node detection, MRI had 100% specificity and a NPV of 94.19%.
Conclusion MRI and clinical examination had comparable sensitivity, specificity and diagnostic accuracy for determining tumor size, vaginal and parametrial involvement. Hence in developing countries where routine radiological imaging may not be cost effective for early cervical cancers, it may be prudent to stick to clinical examination for staging and rely on pathology for nodal involvement
Disclosures The authors have no conflict of interest