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

X-ray computed tomography (CT) was performed in 182 cases of untreated cervical carcinoma, and the CT findings were compared with operative findings and pathological specimens in surgically treated 127 cases, and with post-therapeutic CT findings in irradiated 55 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 (256 parametria), the diagnostic value of CT was manifested by a sensitivity of 67%, a specificity of 91%, and an accuracy of 86%. 3) In detecting paravaginal and vesical extension, CT was superior to conventional diagnostic methods, and the accuracy of CT in 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 manifested by a specificity of 100%, and an accuracy of 89%, although the sensitivity was only 26%, when lymph node images with 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)