ArticleEuropean radiology2026
Accuracy and clinical impact of MRI in early-stage cervical cancer after cervical conization, a retrospective study.
Article in European radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Shaping surgical decisions: a practical MRI approach to cervical stromal invasion assessment in the post-SHAPE era.Abdominal radiology (New York) · 2026Review
- Occult cervical microinvasive squamous cell carcinoma with superficial endometrial spread mimicking high-grade squamous intraepithelial lesion in a postmenopausal woman: a case report.Frontiers in medicine · 2026Article
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12 authors.
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Abstract
objectiveTo assess the accuracy of MRI in detecting residual disease after conization in patients with early-stage cervical cancer (CC) and to evaluate the impact of MRI on FIGO staging and surgical management. MATERIALS AND
methodsBetween January 2018 and December 2023, a consecutive series of patients with early-stage invasive CC undergoing conization, pre-operative pelvic MRI, and surgery were included in this retrospective study. Two experienced radiologists reviewed the MRI scans for the presence of residual tumor, assessed on T2-weighted, diffusion-weighted, and contrast-enhanced sequences, if available. MRI findings were compared with surgical pathology to evaluate diagnostic performance and clinical impact.
resultsA total of 108 patients were included in the study. MRI detected residual disease with an accuracy of 78.7% (95% CI 71.0-86.4), sensitivity of 66%, specificity of 90.9%, positive predictive value of 87.5%, and negative predictive value of 73.5%. The use of contrast agent showed no significant difference in overall accuracy, with an accuracy of 74.5% for contrast-enhanced MRI (CE-MRI) and 83% for non-CE-MRI (p = 0.28), respectively. MRI correctly staged 73.8% of cases, suggested the correct extent of radicality in 79.7% of cases following the 2018 ESGO guidelines, and the appropriate type of hysterectomy (simple vs. radical) in 90.9% of cases following the SHAPE study.
conclusionNon-CE MRI is a reliable and sufficient tool for detecting residual tumor after conization in early-stage CC, as contrast administration offers no additional diagnostic value. Accurate pre-operative identification of residual disease may refine FIGO staging and assist in tailoring surgical strategies. KEY POINTS: Question MRI evaluation of residual tumor after cervical conization in early-stage cervical cancer is critical to optimize surgical planning noninvasively and avoid overtreatment. Findings MRI correctly identified residual disease with high specificity (90.9%) and moderate sensitivity (66%); contrast enhancement did not significantly improve diagnostic accuracy. Clinical relevance MRI, particularly non-contrast protocols, reliably excludes post-conization residual disease and aids in selecting appropriate surgical treatment, reducing overtreatment in early-stage cervical cancer.
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