MR Imaging for Staging of Cervical Carcinoma: Update

Abstract

Cervical cancer is globally the third most common cancer among women, having frequent mortality. About 85% of cervical cancer occurs in the developing countries. The most important risk factors for cervical cancer include human papillomavirus exposure, age of first sexual intercourse, multiple sexual partners, multiparity, low socioeconomic status, and high risk sexual partners (1).Squamous cell carcinoma accounts for about 80% cases of cervical carcinoma. The 20% of nonsquamous cervical carcinoma are adenocarcinoma, adenosquamous carcinoma, adenocystic carcinoma, small cell carcinoma, lymphoma, and undifferentiated carcinoma. Adenocarcinomas show a higher frequency of lymphatic and hematogenous metastasis (2). Most cervical squamous cell carcinomas originate from the squamocolumnar junction (SCJ). In younger females, the SCJ is located outside the external os, and the tumor tends to show exophytic masses.In older females, the SCJ is located within the cervical canal, and the disease tends to display endocervical masses (3). Gradual changes of the epithelium develop into cervical carcinomas; from progressively severe dysplasia to carcinoma in situ (CIS) to invasive carcinoma. The recognition of this progression and its detection with papanicolaou (PAP) smear and biopsy, has led to striking improvements in the mortality rate.Cervical carcinoma is clinically staged according to the International Federation of Gynecology and Obstetrics (FIGO) staging system. Updated in 2009, FIGO is commonly used for scheduling the treatment of cervical carcinoma. The TNM staging system is based on the same criteria as the FIGO staging system