Magnetic resonance imaging and ultrasound examination in
preoperative pelvic staging of early-stage cervical cancer:
post-hoc analysis of SENTIX study

J 2025

Magnetic resonance imaging and ultrasound examination in preoperative pelvic staging of early-stage cervical cancer: post-hoc analysis of SENTIX study

CIBULA, D.; C. KOHLER; Jiří JARKOVSKÝ; R. KOCIAN; P. DUNDR et. al.

Basic information

Original name

Magnetic resonance imaging and ultrasound examination in preoperative pelvic staging of early-stage cervical cancer: post-hoc analysis of SENTIX study

Authors

CIBULA, D. (203 Czech Republic); C. KOHLER (203 Czech Republic); Jiří JARKOVSKÝ (203 Czech Republic, belonging to the institution); R. KOCIAN (203 Czech Republic); P. DUNDR (203 Czech Republic); J. KLAT (203 Czech Republic); I. ZAPARDIEL; F. LANDONI; F. FRUHAUF; R. FISCHBACH; M. BORCINOVA (203 Czech Republic) and D. FISCHEROVA (203 Czech Republic)

Edition

ULTRASOUND IN OBSTETRICS & GYNECOLOGY, HOBOKEN, WILEY-BLACKWELL, 2025, 0960-7692

Other information

Language

English

Type of outcome

Article in a journal

Field of Study

30214 Obstetrics and gynaecology

Country of publisher

United States of America

Confidentiality degree

is not subject to a state or trade secret

References:

URL

Impact factor

Impact factor: 6.100 in 2023

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1002/uog.29205

UT WoS

001451010600001

EID Scopus

2-s2.0-105001653170

Keywords in English

cervical cancer; clinical staging; FIGO; imaging; MRI; ultrasound

Abstract

V originále

Objectives SENTIX was a prospective, single-arm, international multicenter study that evaluated sentinel lymph node biopsy without pelvic lymph node dissection in patients with early-stage cervical cancer. We aimed to evaluate the concordance between preoperative imaging modalities (magnetic resonance imaging (MRI) and ultrasound) and final pathology in the clinical staging of early-stage cervical cancer by post-hoc analysis of the SENTIX study data. Methods In total, 47 sites across 18 countries participated in the SENTIX study. Patients with Stage IA1/lymphovascular space invasion-positive to IB2 (International Federation of Gynecology and Obstetrics (FIGO) classification (2018)) cervical cancer, with usual histological types and no suspicious lymph nodes on imaging, were prospectively enrolled between May 2016 and October 2020. Preoperative pelvic clinical staging on either pelvic MRI or ultrasound examination was mandatory. Tumor size discrepancy (< 10 mm vs ≥ 10 mm) between imaging and pathology, as well as the negative predictive value (NPV) of MRI and ultrasound for parametrial involvement and lymph node macrometastasis, were analyzed. Results Among 690 eligible prospectively enrolled patients, MRI and ultrasound were used as the staging imaging modality in 322 (46.7%) and 298 (43.2%) patients, respectively. A discrepancy of tumor size ≥ 10 mm was reported between ultrasound and final pathology in 39/298 (13.1%) patients and between MRI and pathology in 53/322 (16.5%), with no significant difference in the accuracy of tumor measurement between the two imaging modalities. The NPV of ultrasound in assessing parametrial infiltration and lymph node involvement was 97.0% (95% CI, 0.95–0.99%) and 94.0% (95% CI, 0.91–0.97%), respectively, and that of MRI was 95.3% (95% CI, 0.93–0.98%) and 94.1% (95% CI, 0.92–0.97%), respectively, with no significant differences between the parameters. Ultrasound and MRI were comparable regarding the tumor size measurement (P = 0.452), failure to detect parametrial involvement (P = 0.624) and failure to detect macrometastases in sentinel lymph node (P = 0.876). Conclusions Pelvic ultrasound examination and MRI had similar concordance with histology in the assessment of tumor size and of parametrial and lymph node invasion in early-stage cervical cancer. Ultrasound examination should be considered part of preoperative pelvic clinical staging in early-stage cervical cancer, especially in limited-resource regions where MRI is unavailable. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Links

LM2023033, research and development project

Name: Síť českých biobank

Investor: Ministry of Education, Youth and Sports of the CR

Cite

CIBULA, D.; C. KOHLER; Jiří JARKOVSKÝ; R. KOCIAN; P. DUNDR; J. KLAT; I. ZAPARDIEL; F. LANDONI; F. FRUHAUF; R. FISCHBACH; M. BORCINOVA and D. FISCHEROVA. Magnetic resonance imaging and ultrasound examination in preoperative pelvic staging of early-stage cervical cancer: post-hoc analysis of SENTIX study. ULTRASOUND IN OBSTETRICS & GYNECOLOGY. HOBOKEN: WILEY-BLACKWELL, 2025, vol. 65, No 4, p. 495-502. ISSN 0960-7692. Available from: https://dx.doi.org/10.1002/uog.29205.

@article{2501041,
   author = {Cibula, D. and Kohler, C. and Jarkovský, Jiří and Kocian, R. and Dundr, P. and Klat, J. and Zapardiel, I. and Landoni, F. and Fruhauf, F. and Fischbach, R. and Borcinova, M. and Fischerova, D.},
   article_location = {HOBOKEN},
   article_number = {4},
   doi = {http://dx.doi.org/10.1002/uog.29205},
   keywords = {cervical cancer; clinical staging; FIGO; imaging; MRI; ultrasound},
   language = {eng},
   issn = {0960-7692},
   journal = {ULTRASOUND IN OBSTETRICS & GYNECOLOGY},
   title = {Magnetic resonance imaging and ultrasound examination in preoperative pelvic staging of early-stage cervical cancer: post-hoc analysis of SENTIX study},
   url = {https://obgyn.onlinelibrary.wiley.com/doi/10.1002/uog.29205},
   volume = {65},
   year = {2025}
}

TY  - JOUR
ID  - 2501041
AU  - Cibula, D. - Kohler, C. - Jarkovský, Jiří - Kocian, R. - Dundr, P. - Klat, J. - Zapardiel, I. - Landoni, F. - Fruhauf, F. - Fischbach, R. - Borcinova, M. - Fischerova, D.
PY  - 2025
TI  - Magnetic resonance imaging and ultrasound examination in preoperative pelvic staging of early-stage cervical cancer: post-hoc analysis of SENTIX study
JF  - ULTRASOUND IN OBSTETRICS & GYNECOLOGY
VL  - 65
IS  - 4
SP  - 495-502
EP  - 495-502
PB  - WILEY-BLACKWELL
SN  - 09607692
KW  - cervical cancer
KW  - clinical staging
KW  - FIGO
KW  - imaging
KW  - MRI
KW  - ultrasound
UR  - https://obgyn.onlinelibrary.wiley.com/doi/10.1002/uog.29205
N2  - Objectives SENTIX was a prospective, single-arm, international multicenter study that evaluated sentinel lymph node biopsy without pelvic lymph node dissection in patients with early-stage cervical cancer. We aimed to evaluate the concordance between preoperative imaging modalities (magnetic resonance imaging (MRI) and ultrasound) and final pathology in the clinical staging of early-stage cervical cancer by post-hoc analysis of the SENTIX study data. Methods In total, 47 sites across 18 countries participated in the SENTIX study. Patients with Stage IA1/lymphovascular space invasion-positive to IB2 (International Federation of Gynecology and Obstetrics (FIGO) classification (2018)) cervical cancer, with usual histological types and no suspicious lymph nodes on imaging, were prospectively enrolled between May 2016 and October 2020. Preoperative pelvic clinical staging on either pelvic MRI or ultrasound examination was mandatory. Tumor size discrepancy (< 10 mm vs ≥ 10 mm) between imaging and pathology, as well as the negative predictive value (NPV) of MRI and ultrasound for parametrial involvement and lymph node macrometastasis, were analyzed. Results Among 690 eligible prospectively enrolled patients, MRI and ultrasound were used as the staging imaging modality in 322 (46.7%) and 298 (43.2%) patients, respectively. A discrepancy of tumor size ≥ 10 mm was reported between ultrasound and final pathology in 39/298 (13.1%) patients and between MRI and pathology in 53/322 (16.5%), with no significant difference in the accuracy of tumor measurement between the two imaging modalities. The NPV of ultrasound in assessing parametrial infiltration and lymph node involvement was 97.0% (95% CI, 0.95–0.99%) and 94.0% (95% CI, 0.91–0.97%), respectively, and that of MRI was 95.3% (95% CI, 0.93–0.98%) and 94.1% (95% CI, 0.92–0.97%), respectively, with no significant differences between the parameters. Ultrasound and MRI were comparable regarding the tumor size measurement (P = 0.452), failure to detect parametrial involvement (P = 0.624) and failure to detect macrometastases in sentinel lymph node (P = 0.876). Conclusions Pelvic ultrasound examination and MRI had similar concordance with histology in the assessment of tumor size and of parametrial and lymph node invasion in early-stage cervical cancer. Ultrasound examination should be considered part of preoperative pelvic clinical staging in early-stage cervical cancer, especially in limited-resource regions where MRI is unavailable. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
ER  -

CIBULA, D.; C. KOHLER; Jiří JARKOVSKÝ; R. KOCIAN; P. DUNDR; J. KLAT; I. ZAPARDIEL; F. LANDONI; F. FRUHAUF; R. FISCHBACH; M. BORCINOVA and D. FISCHEROVA. Magnetic resonance imaging and ultrasound examination in preoperative pelvic staging of early-stage cervical cancer: post-hoc analysis of SENTIX study. \textit{ULTRASOUND IN OBSTETRICS \&{} GYNECOLOGY}. HOBOKEN: WILEY-BLACKWELL, 2025, vol.~65, No~4, p.~495-502. ISSN~0960-7692. Available from: https://dx.doi.org/10.1002/uog.29205.

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