Predictive value of computerized tomography in the presurgical evaluation of primary carcinoma of the cervix.

To determine the predictive value of abdominal-pelvic CT scan in assessing pelvic and paraaortic node metastases in untreated cervical carcinoma, the preoperative CT scans of 61 patients were compared with the gross and microscopic surgical findings. Although 75% of enlarged pelvic nodes on CT contained metastases, and 97% of patients with negative pelvic nodes had negative CT scans (specificity = 97%), histologically positive pelvic nodes were often missed on CT scan (sensitivity = 25%). For paraaortic nodes the CT scan had a specificity of 100% and a sensitivity of 67%. No paraaortic nodes were enlarged in stages I-IIA (0/51). CT scans are recommended for routine evaluation of paraaortic nodes in stages II-IV, but are not warranted in pretreatment evaluation of the pelvic nodes in stage I.