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In reply: We appreciate Dr. Choi and colleagues' interest in our recent paper describing pelvic examination and imaging modality for the evaluation of tumor size in cervical cancer. These authors have raised interesting questions and made detailed clarifications of some issues regarding this controversial topic.
As the authors mentioned, CT and MR imaging might have different resolution. We agreed with their description, and our draft also demonstrated this limitation. The accuracy of cervical mass measured only by MRI was superior to that measured by CT or MRI in previous study1-4 as well as the reference which they described.5 In the subgroup analysis which we have performed after publication, MRI was more accurate than CT for the evaluation of cervical mass in 25 patients who underwent both CT and MRI, even though small number and even without statistically significance (p=0.06).
For the term, "clinically visible tumor", we do think that this expression leads the readers to confusion. We measured cervical mass not only by vision but by palpation as we mentioned in the section "protocol for diagnostic work up". And it is better to change the term to "clinically detectable tumor".
Dr. Choi et al. commented that the discrepancies between our paper and previous data, and we agreed that this study showed important data for us.6 However we do not think there was big discrepancy on the point of rs, even we could not compare the values of two studies directly. Above all, we assented to the superiority of MRI to CT. We just intended to propose that the studies in 90's and early 2000's have overestimated the role of imaging tools than recent studies.
About the last comment, 8 mm-sized paper seems very attractive tools for measurement of mass. Although we commonly use scale in millimeter attached on an eye lens in colposcopy, the papers might be good alternatives in many cases.