Prätherapeutische Bestimmung des Tumorstadiums bei Patientinnen mit Zervixkarzinom - Vergleich von klinischer Untersuchung, NMR und CT

PURPOSE: This study was designed to compare the diagnostic accuracy of clinical evaluation, MR imaging and computed tomography in patients with cervical cancer. The detection of lymph node metastases in tomography and MR imaging was additionally analyzed. MATERIAL AND METHODS: A retrospective analysis was carried out of 190 patients with cervical cancer who underwent primary surgical treatment at the University Hospital Hamburg-Eppendorf from 1 Jan 1995 to 31 Dec 2005. The results of 157 clinical evaluations, 41 MR imagings and 35 computed tomographies were compared to the postoperative histopathological findings. RESULTS: In 76 % the clinical staging corresponded to the histopathological findings. Staging with MR and computed tomography was identical with pathology in 46 and 34 %, respectively. The stage of disease was overestimated in 14 % of the clinical evaluations, in 34 % of MR imagings and in 37 % of the computed tomographies. Underestimation occurred in 10 % of the clinical evaluations, in 20 % of the MR imagings and in 29 % of the computed tomographies. The sensitivity and specificity for the detection of lymph node metastases were 33 and 88 % for computed tomography and 30 and 90 % for MR imaging. CONCLUSIONS: In patients with cervical cancer, clinical evaluation is superior to both tomography and MR imaging for the determination of the FIGO stage.