MR Imaging of Cervical Carcinoma: A Practical Staging Approach

Nicolet, Viviane; Carignan, L; Bourdon, Franck; Prosmanne, O

doi:10.1148/radiographics.20.6.g00nv111539

Cited by 165 publications

(131 citation statements)

References 12 publications

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“…The majority of recurrences occur within 2 years of diagnosis, and the prognosis is poor with most patients dying as a result of uncontrolled disease (12). The total pelvic failure rate and 10-year actuarial incidence of distant metastasis in stage III disease is approximately two times higher than in stage IIB (13,14). These data indicate the importance of stage IIIB diagnosis in helping to determine prognosis prior to treatment.…”

Section: Discussionmentioning

confidence: 98%

Correlation of clinical and MRI staging in cervical carcinoma treated with radiation theraphy-single centre experience

Engin

Küçücük²,

Olmez³

et al. 2010

Diagn Interv Radiol

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44T he most important prognostic factors for cervical cancer are tumor stage and size. Although not included in the International Federation of Gynecology and Obstetrics (FIGO) staging, the presence and extent of nodal involvement is an another important prognostic factor (1-3). The efficacy of magnetic resonance imaging (MRI) for the assessment of parametrial involvement (which is important in the primary treatment) of cervical carcinoma is widely recognized. Furthermore, the high accuracy of MRI for evaluating tumor volume and lymph node involvement is well known. In women with stage IIIB cervical tumors, the rates of recurrence, persistent disease in the pelvis, or distant metastases are very different from those of stage IIB disease (4). There are a few reports with a limited number of patients with stage IIIB cervical carcinoma that describe the accuracy of MRI for the assessment of pelvic sidewall invasion by advanced stage cervical tumors (5, 6).The aim of the present study is to correlate clinical and MRI findings in patients with cervical carcinoma treated with radiation therapy (RT). Materials and methods Patient selectionThis analysis was performed at a single radiation oncology department between 1996 and 2005 and included 42 previously untreated patients with cervical carcinoma who were then treated with either radiation alone or concomitant chemoradiotherapy for definitive treatment. The histopathologic diagnosis was squamous carcinoma in 37/42 patients (87.5 %) and adenocarcinoma in 5/42 patients (12.5%). Median patient age was 54.5 years (range, 27-74).The staging workup implemented the FIGO staging system used by a team of radiation oncologists and gynecologic oncologists and was assessed with rectovaginal examinations under general anesthesia prior to RT. MRI was performed for all patients before the initiation of RT. MRI was performed at least 3 weeks after each biopsy and within 15 days before RT. At the conclusion of the external RT, just before brachytherapy, the response to treatment was once again evaluated under general anesthesia. MRI protocolMRI studies were performed using a 1.0-T (Magnetom Impact, Siemens, Erlangen, Germany) or 1.5-T (Magnetom Vision, Siemens) magnet system with a consistent imaging protocol. For this protocol, transverse and sagittal T1-weighted spin-echo (SE) images and transverse T1-weighted fat-saturated images of the pelvis were obtained before and after contrast enhancement with gadopentetate dimeglumine. Transverse and sagittal T2-weighted fast SE sequences of the pelvis were also obtained. Imaging parameters are summarized in Table 1. ABDOMINAL IMAGING ORIGINAL ARTICLE Correlation of clinical and MRI staging in cervical carcinoma treated with radiation therapy: a single-center experienceGülgün Engin, Seden Küçücük, Hatice Ölmez, Zehra Işık Haşıloğlu, Rian Dişçi, Işık Aslay MATERIALS AND METHODSForty-two patients with pretreatment IB-IVA cervical carcinoma were included in this retrospective study. Pre-and post-treatment MRI findings of the patients were reev...

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Section: Discussionmentioning

confidence: 98%

Correlation of clinical and MRI staging in cervical carcinoma treated with radiation theraphy-single centre experience

Engin

Küçücük²,

Olmez³

et al. 2010

Diagn Interv Radiol

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“…Chemotherapy and radiation: Stages IB2, IIA2 and IIB or higher While MRI is recommended but not required for staging patients with cervical carcinoma (excluding IA), it is the best modality for identifying tumor location, tumor size (93% of cases within 5 mm), parametrial, pelvic sidewall and/or adjacent organ invasion and enlarged lymph nodes [22,23]. This is important because tumor size correlates with lymph node involvement, prognosis and patient outcome [22,24]. In fact, NCCN guidelines do promote MRI to exclude tumor high in the endocervix [25] reflecting the underestimation of extent of tumor on clinical examination.…”

Section: Methodsmentioning

confidence: 99%

Thursday 17th October 2013

2013

J Med Imag Rad Onc

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“…The thin low signal intensity wall on T2-weighted images are effaced if the vaginal tunica muscularis is invaded (1,20). MR imaging is highly sensitive and has an accuracy of 93% in depiction of vaginal extension (46).…”

Section: Vaginal Invasionmentioning

confidence: 99%

MR Imaging for Staging of Cervical Carcinoma: Update

Yoon

Kim

2017

J Korean Soc Radiol

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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

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MR Imaging of Cervical Carcinoma: A Practical Staging Approach

Cited by 165 publications

References 12 publications

Correlation of clinical and MRI staging in cervical carcinoma treated with radiation theraphy-single centre experience

Correlation of clinical and MRI staging in cervical carcinoma treated with radiation theraphy-single centre experience

Thursday 17th October 2013

MR Imaging for Staging of Cervical Carcinoma: Update

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