« Back
MR staging accuracy in cervical cancer - correlation with post-surgical pathology in stage IB1
Poster Title: MR staging accuracy in cervical cancer - correlation with post-surgical pathology in stage IB1
Submitted on 13 Sep 2018
Author(s): Dr Catriona Turbet, Dr Fiona Bryden, Dr David Millan
This poster was presented at BIR Annual Congress 2018
Poster Views: 350
View poster »

Poster Information
Abstract: Background
Accurate pre-operative staging of cervical carcinoma is crucial in determining appropriate management. Stage IB1 encompasses clinically visible tumours <4cm, confined to cervix. These tumours are amenable to radical surgical management.

• Determine local cervical cancer MR staging accuracy
• Explore possible reasons for overcall/undercall

Retrospective review of all patients diagnosed with Stage IB1 cervical carcinoma in NHS Greater Glasgow and Clyde over a 24 month period (Jan 2013–Dec 2014), n=38.
Data collected on pre-operative procedures/pathology, MR staging and final pathology.

Concordance 52%, MR overcall 21%, MR undercall 24%, staging correct but site discrepancy 3%.
Examining data subdivided by pathological subtype revealed the following:
• MR staging correct in 62.5% of squamous carcinomas but only 46% of adenocarcinomas
• Staging underestimated in 38% of adenocarcinomas, compared with 12.5% of squamous carcinomas
Sites of MR overcall included vaginal fornices and parametrium. 50% of MR overcalls were poorly differentiated. 25% of MR overcalls were in cases of no residual tumour on final pathology, despite being tumour present at LLETZ margins.
In cases of concordance between MR and pathology, 65% had IV contrast (no impact on overcall/undercall rates, however).

Overall concordance rate of 52%. Adenocarcinoma is difficult to accurately stage and is frequently undercalled. Poorly differentiated tumours are more likely to be overcalled, which may be attributable to a surrounding inflammatory flare and desmoplastic reaction(1). Vaginal fornix overcall is recognised but acceptable, as this region is better assessed clinically(2) and will not alter management. Contrast administration confers a higher concordance rate.
Summary: Please see abstractReferences: 1. Dr David Millan, Consultant Pathologist NHS GG&C.
2. Shue M-H, Chang C-Y, et al MR staging of clinical stage I and IIa cervical carcinoma : a reappraosal of efficacy and pitfalls Eur J Rad (2001) 38; 225-231
Report abuse »
Creative Commons

Related Posters

Quality of care provided to diabetic patients attending primary health care centers in National Guard in Makkah Region, Saudi Arabia
Sultan Ahmed Alghamdi, MD.

Modelling recurrent event data: a comparison of the Cox proportional hazards model and three of its extensions to estimate the risk of recurrent healthcare-associated infections in critically ill patients
Evangelos I. Kritsotakis, Guillermo Castilla Fernandez, Mark Strong

Acetabular socket size templating with femoral head diameter and pelvic x-ray A novel surgical technique
Kalaivanan Kanniyan , Shantanu Patil , Ashok Kumar PS, Vijay C Bose , Suryanarayan Pitchai

Dr Nesrine Hammoudi ; Dr Salim Kara Mostefa ; Dr Mokhtar Nehhal

Brito-Carmona R.D., Cuendis-Velázquez A., Bada Yllan O., Valenzuela-Salazar C. Campos-Badillo J.A. Serrano-Andrade F.X.