MRI characteristics for predicting histological subtypes in patients with uterine cervical adenocarcinoma

Purpose: To evaluate the magnetic resonance imaging (MRI) findings of uterine cervical adenocarcinoma for predicting different histological subtypes.Materials and methods: We retrospectively analyzed MRI findings of 76 consecutive patients with histopathologically-confirmed uterine cervical adenocarcinoma undergoing preoperative MRI examination. An experienced pathologist classified the histological subtypes based on World Health Organization's 2020 classi-fication and into human papillomavirus (HPV)-associated adenocarcinomas (HPVAs, n = 54) (usual type and variants) and HPV-independent adenocarcinomas (HPVIs, n = 22) (gastric type adenocarcinoma (GAS), clear cell type, and other types). Different MRI variables were compared quantitatively and qualitatively between HPVA and HPVI and between GAS and non-GAS tumor types.Results: The maximum tumor diameter was significantly greater in HPVIs than HPVAs (41.9 +/- 18.6 vs 32.7 +/- 15.6 mm; p < 0.05). Heterogeneous enhancement on fat-suppressed gadolinium-enhanced T1-weighted images was more frequently seen in HPVIs than HPVAs (62 % vs 15 %; p < 0.01) and in GASs than non-GASs (78 % vs 16 %; p < 0.01). Also, infiltrative growth pattern (58 % vs 20 %; p < 0.05) and intratumoral cyst formation (83 % vs 47 %) (p < 0.05) were more frequent in GASs than non-GASs.Conclusions: Compared with HPVAs, HPVIs tend to have a larger tumor size with heterogeneous enhancement, of which GASs frequently show infiltrative growth patterns with intratumoral cyst formation and heterogeneous enhancement.

Automated summary

The purpose of this study is to evaluate the MRI findings of uterine cervical adenocarcinoma for predicting different histological subtypes. The results show significant differences between HPV-associated adenocarcinomas (HPVAs) and HPV-independent adenocarcinomas (HPVIs) in MRI findings, with HPVIs having larger tumor size and heterogeneous enhancement. Gastric type adenocarcinomas (GASs) also show infiltrative growth patterns, intratumoral cyst formation, and heterogeneous enhancement.