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Three radiologists independently recorded MRI\u2013derived staging parameters incorporated in the 2018 FIGO staging system. Kappa coefficients (\n                      <jats:italic>\u03ba<\/jats:italic>\n                      ) for interobserver agreement were calculated. The predictive and prognostic values of the MRI parameters were explored using ROC analyses and Kaplan\u2013Meier with log-rank tests, and analyzed in relation to clinicopathological patient characteristics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall agreement was substantial for the staging parameters: tumor size &gt; 2 cm (\n                      <jats:italic>\u03ba<\/jats:italic>\n                      = 0.80), tumor size &gt; 4 cm (\n                      <jats:italic>\u03ba<\/jats:italic>\n                      = 0.76), tumor size categories (\u2264 2 cm; &gt; 2 and \u2264 4 cm; &gt; 4 cm) (\n                      <jats:italic>\u03ba<\/jats:italic>\n                      = 0.78), parametrial invasion (\n                      <jats:italic>\u03ba<\/jats:italic>\n                      = 0.63), vaginal invasion (\n                      <jats:italic>\u03ba<\/jats:italic>\n                      = 0.61), and enlarged lymph nodes (\n                      <jats:italic>\u03ba<\/jats:italic>\n                      = 0.63). Higher MRI\u2013derived tumor size category (\u2264 2 cm; &gt; 2 and \u2264 4 cm; &gt; 4 cm) was associated with a stepwise reduction in survival (\n                      <jats:italic>p<\/jats:italic>\n                      \u2264 0.001 for all). Tumor size &gt; 4 cm and parametrial invasion at MRI were associated with aggressive clinicopathological features, and the incorporation of these MRI\u2013based staging parameters improved risk stratification when compared to corresponding clinical assessments alone.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The interobserver agreement for central MRI\u2013derived 2018 FIGO staging parameters was substantial. MRI improved the identification of patients with aggressive clinicopathological features and poor survival, demonstrating the potential impact of MRI enabling better prognostication and treatment tailoring in cervical cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:italic>\u2022 The overall interobserver agreement was substantial (\u03ba values 0.61\u20130.80) for central MRI staging parameters in the 2018 FIGO system.<\/jats:italic>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:italic>\u2022 Higher MRI\u2013derived tumor size category was linked to a stepwise reduction in survival (p \u2264 0.001 for all).<\/jats:italic>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:italic>\u2022 MRI\u2013derived tumor size &gt; 4 cm and parametrial invasion were associated with aggressive clinicopathological features, and the incorporation of these MRI\u2013derived staging parameters improved risk stratification when compared to clinical assessments alone.<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00330-022-08666-x","type":"journal-article","created":{"date-parts":[[2022,3,25]],"date-time":"2022-03-25T01:03:08Z","timestamp":1648170188000},"page":"6444-6455","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Interobserver agreement and prognostic impact for MRI\u2013based 2018 FIGO staging parameters in uterine cervical cancer"],"prefix":"10.1007","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6309-0507","authenticated-orcid":false,"given":"Kari S.","family":"Wagner-Larsen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nj\u00e5l","family":"Lura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d8yvind","family":"Salvesen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mari Kylles\u00f8","family":"Halle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Forsse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jone","family":"Trovik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noeska","family":"Smit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Krakstad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingfrid S.","family":"Haldorsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,3,24]]},"reference":[{"key":"8666_CR1","doi-asserted-by":"publisher","unstructured":"Sung H, Ferlay J, Siegel RL et al (2021) Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. 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Haldorsen.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Guarantor"}},{"value":"\u00d8yvind Salvesen (one of the co-authors) is an expert in medical statistics.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statistics and Biometry"}},{"value":"The presented study subjects are all included in the biobank for cervical cancer and clinical database at our institution, and overlapping cases have been presented in previous publications primarily focusing on clinicopathologic and molecular\/genetic markers in cervical cancer. One previous small study (n = 53) have presented PET-CT parameters for overlapping cases included in this MRI study but with an entirely different aim and no overlapping results.Halle MK, S\u00f8dal M, Forsse D et al (2021) A 10-gene prognostic signature points to LIMCH1 and HLA-DQB1 as important players in aggressive cervical cancer disease. Br J Cancer. 10.1038\/s41416-021-01305-0Halle MK, Ojesina AI, Engerud H et al (2017) Clinicopathologic and molecular markers in cervical carcinoma: a prospective cohort study. Am J Obstet Gynecol 217:432.e431-432.e417Halle MK, Krakstad C, Engerud H, Bertelsen B, Salvesen HB (2014) Molecular profiling in fresh tissue with high tumor cell content promotes enrichment for aggressive adenocarcinomas in cervix. Pathol Res Pract 210:774-778Bollineni VR, Ytre-Hauge S, Gulati A et al (2018) The prognostic value of preoperative FDG-PET\/CT metabolic parameters in cervical cancer patients. European Journal of Hybrid Imaging 2:24","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Study subjects or cohorts overlap"}},{"order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}