MR imaging underestimates stromal invasion in patients with adenocarcinoma of the uterine cervix

Purpose of investigation: To evaluate magnetic resonance (MR) imaging in assessing the depth of stromal invasion in patients with adenocarcinoma of the uterine cervix. Methods: Twenty-three women with adenocarcinoma of the cervix underwent T2-weighted and dynamic MR imaging before surgical evaluation. The images were evaluated for the depth of stromal invasion and compared with histological results. Results: Twelve of 23 patients (52%) were correctly diagnosed in agreement with the histological findings. However, the depth of stromal invasion was underestimated in ten patients (44%). In four of nine patients who exhibited scattered type lesions, no lesions were detected by MR imaging, although deep stromal invasion (more than 1/3) was recognized histologically. In contrast, all 11 patients showed cancer lesions in solid type adenocarcinomas with deep stromal invasion. Conclusion: MR imaging detected less stromal invasive lesions in adenocarcinoma of the cervix than surgical specimens, and some scattered type adenocarcinomas could not be visualized.