Is MRI helpful in assessing the distance of the tumour from the internal os in patients with cervical cancer below FIGO Stage IB2?

•Cervical cancer patients who underwent hysterectomy were analyzed on MRI and pathology for involvement of the internal os.•Distance of the tumor from the internal-os was measured on MRI and Pathology and findings were tabulated as > and ≤ 5 mm from the internal os.•MRI has the ability to identify tumor involvement of the internal os.•MRI can help select patients who can undergo trachelectomy safely.

AimTo determine the ability of magnetic resonance imaging (MRI) in detecting tumour-free margins from the internal os (IO).Materials and methodsA database search yielded 79 women with early-stage cervical cancer who underwent radical hysterectomy and preoperative MRI. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of MRI in assessment of ≤5 and >5 mm IO involvement were calculated with histopathological surgical specimen findings considered to be the reference standard. A main and subset analysis was performed. The subset analysis included only those patients who would have been considered for radical trachelectomy.ResultsFor predicting a distance between the tumour and the IO of ≤5 mm, MRI had a sensitivity of 73%, a specificity of 98.3%, a PPV of 95%, a NPV of 88.1%, and an accuracy of 89.8% for the main analysis, and sensitivity of 81.8%, a specificity of 93.2% a PPV of 69.2% a NPV of 96.5% and an accuracy of 91.4% for the subset analysis.ConclusionMRI has high specificity, NPV, and accuracy in detecting tumour from the IO, making MRI suitable for treatment planning in patients desiring trachelectomy to preserve fertility.