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Purpose <p>To evaluate the diagnostic performance and inter-reader reliability of an abbreviated non-angulated three-plane T2-weighted pelvic MRI protocol for assessing local staging key parameters in cervical cancer.</p> Methods <p>In this retrospective single-center study, 47 patients with cervical cancer who underwent pelvic MRI between January 2023 and December 2024 were included. MRI was performed on a 1.5-T system using a simplified protocol; image interpretation was restricted to axial, sagittal, and coronal T2-weighted turbo spin-echo sequences. Two board-certified radiologists (one subspecialized in gynecological imaging, one general radiologist) independently assessed tumor size, parametrial invasion, vaginal involvement, and local T stage. A composite reference standard consisting of examination under anaesthesia, laparoscopic staging, and histopathology was used. Diagnostic performance metrics and inter-reader agreement (Cohen’s κ, ICC) were calculated.</p> Results <p>Parametrial invasion was detected with high diagnostic accuracy, with a mean sensitivity of 94.0% and specificity of 88.6% across both readers. For vaginal invasion, mean sensitivity and specificity were 95.5% and 96.0%, respectively. Inter-reader agreement was excellent for tumor size measurements (ICC 0.946–0.992) and high for categorical variables categorical variables (κ = 0.828 for parametrial and 0.915 for vaginal invasion). Agreement between MRI and the reference standard for tumor size was good, with mean differences of 3.1–4.8&#xa0;mm. The abbreviated protocol corresponded to an acquisition time of approximately 13&#xa0;min compared to 21&#xa0;min for the simplified institutional protocol and 30–45&#xa0;min for standard multiparametric MRI.</p> Conclusion <p>A non-angulated three-plane T2-weighted pelvic MRI protocol provides high diagnostic accuracy and inter-reader agreement for assessing local staging key parameters in early-stage to locally advanced cervical cancer without bladder or rectal involvement and may represent a feasible alternative in time-constrained or resource-limited settings.</p>

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Abbreviated T2w-only pelvic MRI for local tumor staging of cervical cancer: a pragmatic approach for time-critical and resource-limited settings

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月20日

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  • Moritz T. Winkelmann,
  • Alan Bareiss,
  • Johanna T. Winkelmann,
  • Sascha Hoffmann,
  • Heike Preibsch,
  • Konstantin Nikolaou,
  • Christina B. Walter,
  • Felix Peisen

摘要

Purpose

To evaluate the diagnostic performance and inter-reader reliability of an abbreviated non-angulated three-plane T2-weighted pelvic MRI protocol for assessing local staging key parameters in cervical cancer.

Methods

In this retrospective single-center study, 47 patients with cervical cancer who underwent pelvic MRI between January 2023 and December 2024 were included. MRI was performed on a 1.5-T system using a simplified protocol; image interpretation was restricted to axial, sagittal, and coronal T2-weighted turbo spin-echo sequences. Two board-certified radiologists (one subspecialized in gynecological imaging, one general radiologist) independently assessed tumor size, parametrial invasion, vaginal involvement, and local T stage. A composite reference standard consisting of examination under anaesthesia, laparoscopic staging, and histopathology was used. Diagnostic performance metrics and inter-reader agreement (Cohen’s κ, ICC) were calculated.

Results

Parametrial invasion was detected with high diagnostic accuracy, with a mean sensitivity of 94.0% and specificity of 88.6% across both readers. For vaginal invasion, mean sensitivity and specificity were 95.5% and 96.0%, respectively. Inter-reader agreement was excellent for tumor size measurements (ICC 0.946–0.992) and high for categorical variables categorical variables (κ = 0.828 for parametrial and 0.915 for vaginal invasion). Agreement between MRI and the reference standard for tumor size was good, with mean differences of 3.1–4.8 mm. The abbreviated protocol corresponded to an acquisition time of approximately 13 min compared to 21 min for the simplified institutional protocol and 30–45 min for standard multiparametric MRI.

Conclusion

A non-angulated three-plane T2-weighted pelvic MRI protocol provides high diagnostic accuracy and inter-reader agreement for assessing local staging key parameters in early-stage to locally advanced cervical cancer without bladder or rectal involvement and may represent a feasible alternative in time-constrained or resource-limited settings.