Possibilities and limitations of MRI diagnostics of endocervical adenocarcinomas of the cervix.

Abstract

Backgrounds: Improving the MRI diagnosis of endocervical adenocarcinomas of the cervix, conducting a comparative analysis of MRI data and postoperative pathomorphological examination in assessing tumor invasion into the stroma of the cervix. Matherial and methods: We examined 123 patients diagnosed with cervical cancer (C53), who underwent diagnosis and treatment in the period from 2020 to 2023. We analyzed the results of examination of 22 (18%) patients with cervical adenocarcinoma. The average age of patients with cervical adenocarcinoma was 56 years. A multiparametric magnetic resonance examination of the pelvic organs was performed on 22 patients using tomographs with a magnetic field strength of 1.5 T. Surgical treatment including extirpation of the uterus and appendages with pelvic lymphadenectomy was performed on 14 patients (64%). Results: Over the past 3 years, there has been an increase in cervical adenocarcinoma up to 18%. The information content of MRI in assessing the depth of tumor invasion into the stroma of the cervix was: accuracy- 70%; sensitivity- 85.7%, specificity 33.3%, predictive value of a positive result - 75%, predictive value of a negative result 50%. The 4 types of macrostructure of tumor growth of endocervical adenocarcinoma, identified during the analysis of MR data, indicate locally aggressive tumor growth, a high frequency of dropouts into the endometrium, will allow the radiologist to structure a descriptive MR picture and better develop a treatment plan for the patient. Conclusions: MRI makes it possible to assess the localization, volume, and depth of invasion of cervical adenocarcinoma into the stroma and, thus, is recommended for use in patients with histologically verified cervical adenocarcinoma for the purpose of assessing the local extent of the tumor, staging according to the T criterion and adequate treatment planning and prognosis of the disease.