Role of X-ray computed tomography in the staging of cervical carcinoma

X-ray computed tomography (CT) was performed in 132 cases of untreated cervical carcinoma, and the CT findings were compared with operative findings and pathological specimens in surgically treated cases, and with post-therapeutic CT findings in irradiated cases. The results were as follows. 1) The cervical image was significantly (p<0.01) enlarged in the group in which the diameter of the cancer in the specimen was greater than 2.0 cm. Accordingly, a cervical area exceeding 12.6 cm2 was classified as enlargement of the cervix. 2) With respect to parametrial invasion in surgically proven cases (176 parametria), the diagnostic value of CT was indicated by a sensitivity of 58%, a specificity of 90%, and an accuracy of 83%. 3) In detecting paravaginal and vesical involvement, CT was superior to conventional diagnostic method, and the accuracy of CT in the detection of vesical involvement was 96% in surgically treated cases. 4) The diagnostic value of CT in evaluating lymph node metastases in surgically confirmed cases was indicated by a specificity of 100%, and an accuracy of 88%; although the sensitivity was only 29%, when lymph node images with a maximum diameter exceeding 2.0 cm were regarded as metastases. The above findings indicate that CT provides greater accuracy in the staging of cervical carcinoma, when used with conventional methods. (author)