 Hello everyone, this is Dr. Divya Radhivithal Frimukhi, J.R. Ruvan from P.K. Palawalka Rural Medical College and Hospital, Savarda Chipplun Ratnagiri co-author is Dr. Pradeep Kulkarni, HOD of P.K. Palawalka. My paper presentation topic is Evaluation of role of MRI in staging of Casinoma of cervix. Cervical cancer forms 16.5% of the total cancer cases in Indian women and is the second most common type of cancer. It is estimated that about 160 million women between the age of 30 and 59 years are at risk of developing the cervical cancer in India, with 96,922 new cases registered in 2018 alone. It is a major cause of morbidity and mortality from the cancer. Multifactorial causation, the potential for prevention and the three-eat process make the cervical cancer an important disease for detailed studies. Role of MRI For pretreatment, local staging of tumor, defining pelvic tumor extent, including a more accurate assessment of tumor size, depth of the stromal invasion, lymph nodes, metastasis and also there is no radiation. Imaging an additional to physical examination has been encouraged by the revised Figo staging system. Stage 1 is limited to the cervix. Stage 2 extension to the cervix or parametria or vagina. Stage 3 extension to the pelvic side wall and or the lower third of vagina. Stage 4 extension to the adjacent organ or beyond the two pelvis. In our college, the patient who are not afford to do MRI are mostly funded by Dr. Gurukure initiation and treatment fund. Aim of the study is this is a planned prospective study to find out the efficacy of MRI in finding out of the local extent and spread for the management and staging in the cervical cancer with the histopathological correlation. Objective to localize and characterize cervical malignancy with respect to anatomical delineation, local and distance spread to establish the demographic profile of the cervical malignancies. Methodology, study design, hospital-based prospective study, sample size is 20, source of study, data for the study shall be collected from the BK Valavalka Rural Medical College, Hospital and Chipplun Ratnagiri. Cases of tumor recurrence after treatment shall also be included. Pelvic MRI, females with a diagnosis of cervical casinoma on a pap smear and pap c will be selected and shall undergo MRI pelvis. Machine used is 1.5 tesla. Procedure, multi-fest array coils are recommended. Scan geometry in a plane spatial resolution less than 0.7 into 0.7 mm, filter of view 320 to 360 and slight thickness is less than 3 mm. Standard sequences used are T2 weighted image, T1 weighted image, T1 weighted contrast images and diffusion weighted image. Inclusion criteria's were patient with a diagnosis of cervical cancer, patient with a non-servical pathology, patient who have already undergone a surgery or came a radiation for recurrence, patient with a tumor recurrence after the resection. Exclusion criteria were patient without any non-servical pathology, patient unveiling per study. This is my study. I have a study on the 20 patient in which the MRI has ability to detect a CS service in stage 1 is 0%. In stage 2 is 33.3%. In stage 3 it is 87.5% and in stage 4 it is 100%. Therefore, it is a stage 2 CS service. They are the sagittal and T2 weighted images in which the legion is seen arising in the cervix and lower uterine segment. It shows a heterogeneous T2 mild hyperintense signal involving anterior endometrial lining less than 50%. This is a diffusion weighted image of the same patient and histopathologically it is proven as differentiated adenocarcinoma of cervix. Stage 4. They are the T2 weighted axial and sagittal images. There is a L-defined lobulated mass legion is noted here. It shows an iso-to-hypointed signal intensity. It is seen involving lower uterine body including anterior and posterior wall also abetting with a urinary bladder and rectum. This is the T2 weighted sagittal and axial image of the same patient which shows an endometrial distended endometrial with a circumferential wall thickening more on the posterior aspect. And there is also the legion in the right adenoxa which is a hyperintense on T2 weighted image and hypointense on T1 weighted image. Therefore, it is a follicular legion. And also there is a bilateral adenoxal vessels which are torsious more on the right side. This is the post-contrast study of the same patient which shows the heterogeneous enhancement. Histopathologically it is proven as a large cell non-charitonizing squamous cell carcinoma of cervix. This is another patient. 60-year-old female came to gynecological OPD with a difficulty in maturation, rippling urine and incontinence in three months. No history of perverginal bleeding. On MRI, a symmetrical circumferential wall thickening noted in the cervix involving the posterior wall of the bladder and also the rectum. Therefore, it is a neoplastic etiology stage 4 CA cervix. Histopathologically it is proven as a poorly differentiated infiltrating carcinoma. So, CA cervix is originated from the squamous columnar junction and tends to be more exophotic, whereas in older women it originates more often in the endoservical canal. The bulk of the legion is centered at the level of the cervix with either protrusion into the vagina or invasion of the lower myometrium. This permits the differentiation from an endometrial mass. Differential diagnosis is endometrial mass which is centered in the endometrial cavity but protrudes into the endoservical canal. Prolapse submucosal fibroid are distinctly more hyper intense at a T2-wetted image than the cervical carcinoma. In general, cervical carcinoma is better defined at a T2-wetted imaging but a small tumor may be more readily identified by their early enhancement after the dynamic injection of the gadopentated dimer blue mine. A visible tumor indicates stage 1B or higher. The size of the tumor has a great impact on the choice of the therapy and there is a good correlation between the MR imaging finding and the macroscopic measurements. However, the size of the legion may rarely be overestimated at T2-wetted imaging due to inflammation or edema. The shape and direction of the growth should be noted because they are important for the brachytherapy planning. So, conclusion is sensitivity of MRI to detect stage 4 is 100% is more followed by stage 3 is 87.5% and stage 2 is 33.3%. However, there is no role of MRI in stage 1 tumor. This are my references. Thank you.