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MRI for Pretreatment Lymph Node Staging in Uterine Cervical Cancer

Hyuck Jae Choi1, Seung Hyup Kim2, San-Soo Seo1, Sokbom Kang1, Sun Lee1, Joo-Young Kim1, Young Hoon Kim1, Jong Seok Lee1, Hyun Hoon Chung1, Joo-Hyuk Lee1 and Sang-Yoon Park1

1 Department of Radiology, Research Institute and Hospital, National Cancer Center, 809 Madu 1-dong, Ilsan-gu, Koyang, Kyonggi, Korea 411-769.
2 Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea.


Figure 1
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  		Fig. 1A —37-year-old woman with true-positive left internal iliac lymph node metastasis in stage IIB uterine cervical cancer. MR axial T2-weighted fast spin-echo image (TR/TE, 5,000/68; echo-train length, 21) shows an ovoid lymph node (arrow, 11-mm short-axis diameter) with spiculated border in left internal iliac area.

 

Figure 2
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  		Fig. 1B —37-year-old woman with true-positive left internal iliac lymph node metastasis in stage IIB uterine cervical cancer. Gadolinium-enhanced axial T1-weighted turbo spin-echo sequence image (175/4.2; echo-train length, 3) shows heterogeneous enhancement of left internal node (arrow). Histopathology showed one positive node in left internal iliac and obturator area of six lymph nodes sampled.

 

Figure 3
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  		Fig. 2A —50-year-old woman with true-positive pelvic lymph node metastases in stage IIIA uterine cervical cancer. MR axial T2-weighted fast spin-echo image (TR/TE, 5,000/68; echo-train length, 21) shows elongated lymph node (arrow, 5-mm short-axis diameter) with lobulated margin in left internal iliac area.

 

Figure 4
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  		Fig. 2B —50-year-old woman with true-positive pelvic lymph node metastases in stage IIIA uterine cervical cancer. Gadolinium-enhanced axial T1-weighted turbo spin-echo sequence image (175/4.2; echo-train length, 3) shows heterogeneous enhancement of left internal iliac lymph node (arrow). Histopathology showed one positive node in left internal iliac and obturator area of four nodes sampled.

 

Figure 5
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  		Fig. 3A —48-year-old woman with true-positive left internal iliac lymph node metastasis in stage IIB uterine cervical cancer. MR axial T2-weighted fast spin-echo image (TR/TE, 5,000/68; echo-train length, 21) shows ovoid lymph node (arrow, 10-mm short-axis diameter) with smooth margin in left internal iliac area.

 

Figure 6
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  		Fig. 3B —48-year-old woman with true-positive left internal iliac lymph node metastasis in stage IIB uterine cervical cancer. Gadolinium-enhanced axial T1-weighted turbo spin-echo sequence image (175/4.2; echo-train length, 3) shows homogeneous enhancement of left internal iliac lymph node (arrow). Histopathology showed one positive node in left internal iliac and obturator area of four nodes sampled.

 

Figure 7
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  		Fig. 4A —False-positive pelvic lymph node metastases in 44-year-old woman with stage IIB uterine cervical cancer. MR T2-weighted fast spin-echo axial (A) and coronal (B) images (TR/TE, 5,000/68; echo-train length, 21) show elongated lymph node (arrow, 8-mm short-axis diameter) with spiculated margin in right internal iliac area. Histopathology showed no positive nodes in right internal iliac and obturator area of four nodes sampled.

 

Figure 8
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  		Fig. 4B —False-positive pelvic lymph node metastases in 44-year-old woman with stage IIB uterine cervical cancer. MR T2-weighted fast spin-echo axial (A) and coronal (B) images (TR/TE, 5,000/68; echo-train length, 21) show elongated lymph node (arrow, 8-mm short-axis diameter) with spiculated margin in right internal iliac area. Histopathology showed no positive nodes in right internal iliac and obturator area of four nodes sampled.

 

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