ORIGINAL RESEARCH ARTICLE | Dec. 12, 2025
Diagnostic Accuracy of Preoperative MRI in Predicting Surgicopathological Factors in Early Cervical Cancer
Dr. Jesmin Sultana, Dr. Khairun Nahar, Dr. Liza Tasrin, Dr. Shamim Ara, Dr. Ayesha Siddika Purabi, Dr. Farhana Binty Rashid
Page no 370-379 |
https://doi.org/10.36348/sijog.2025.v08i12.001
Background: Accurate preoperative assessment of surgicopathological factors is essential for optimal management of early cervical cancer. Magnetic resonance imaging (MRI) is widely used for preoperative staging, but its diagnostic accuracy varies across key pathological predictors. This study aimed to evaluate the sensitivity, specificity, and predictive values of MRI in determining surgicopathological factors in early-stage cervical cancer using histopathology as the gold standard. Methods: This prospective cross-sectional study was conducted at the Gynecological Oncology Unit of Dhaka Medical College Hospital from June 2021 to May 2022. Fifty histologically confirmed early-stage cervical cancer patients undergoing primary radical hysterectomy with pelvic lymph node dissection were included. Preoperative MRI assessed tumor size, vaginal extension, parametrial involvement, lymph node metastasis, deep stromal invasion, and corpus extension. MRI findings were compared with clinical examination and final histopathology. Diagnostic accuracy parameters were calculated. Results: Clinically, 94% of tumors were <4 cm, and 14% showed vaginal involvement. MRI demonstrated high accuracy for tumor size assessment with sensitivity 97.87%, specificity 100%, and overall accuracy 98%. For vaginal extension, MRI showed sensitivity 71.43% and specificity 100% with accuracy 96%. MRI detected lymph node metastasis with sensitivity 60%, specificity 91.11%, and accuracy 88%. Deep stromal invasion was identified with 72.41% sensitivity and 71.43% specificity. Corpus extension demonstrated sensitivity 55.56%, specificity 93.75%, and accuracy 80%. Conclusion: MRI is a highly sensitive and specific modality for preoperative evaluation of key surgicopathological factors in early cervical cancer. Its strong concordance with histopathology supports its essential role in guiding surgical planning and staging.