Role of Computed Tomography in the Presurgical Evaluation of Carcinoma of the Cervix

Abstract

Patients (36) with either primary or recurrent carcinoma of the cervix were evaluated by computed tomography (CT) to assess the ability of CT to screen patients prior to radical surgery. Overall accuracy when compared to surgical findings or skinny needle biopsies was 80%. Inaccuracies by CT were the result of inability to assess minimally enlarged lymph nodes, inability to distinguish fibrosis from recurrent tumors, and difficulty in delineating actual tumor invasion versus contiguity of adjacent pelvic organs. Computed tomography proved to be a sensitive indicator in delineating actual tumor bulk and sidewall extension. Information gained by CT compared favorably with that obtained by intravenous urography, barium enemas, lymphangiography, and nuclear medicine bone scans. This comparison indicates that CT can serve as a sensitive imaging modality to assess the surgical candidacy of patients either with initial or recurrent carcinoma of the cervix. An algorithm of studies is proposed based on this preliminary investigation.