MRI of Malignant Neoplasms of the Uterine Corpus and Cervix

Sala, Evis; Wakely, Suzanne; Senior, Emma; Lomas, David J.

doi:10.2214/ajr.06.1196

Cited by 257 publications

(149 citation statements)

References 72 publications

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“…Stage IVA is when the bladder or rectal invasion is considered based on the presence of focal or diffuse disruption of the normally observed low signal intensity wall on T2-weighted images, irregular or nodular wall, and presence of an intraluminal mass (Fig. 11) (27).…”

Section: Stage IVmentioning

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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Section: Stage IVmentioning

confidence: 99%

MR Imaging for Staging of Cervical Carcinoma: Update

Yoon

Kim

2017

J Korean Soc Radiol

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“…There are some important pitfalls in delineating tumor margins and evaluating parametrial invasion on T2-weighted imaging (10). At baseline MRI evaluation, inflammation surrounding the tumor as well as the granulation tissue (post-biopsy changes) can lead to an overestimation of cervical invasion on T2-weighted imaging, because they are characterized by high signal intensity, similar to cancer.…”

Section: Dwi and Adc Map To Avoid Pitfallsmentioning

confidence: 99%

“…Its accuracy is limited in the advanced stages (7). Magnetic resonance imaging (MRI) has been shown to be the most reliable imaging technique in local staging, treatment planning, and follow-up of cervical cancer (8,9), with staging accuracy ranging from 75% to 96% (10). In 2010, National Comprehensive Cancer Network (NCCN-2010) included MRI in the basic work-up of patients suffering from cervical cancer for stages greater than IB1.…”

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confidence: 99%

MRI anatomy of parametrial extension to better identify local pathways of disease spread in cervical cancer

Valentini

Gui²,

Miccò³

et al. 2016

Diagn Interv Radiol

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T here are two main treatment options in patients with cervical cancer: radical surgery, including trachelectomy or radical hysterectomy, which is usually performed in early stage disease as suggested by the International Federation of Gynecology and Obstetrics (FIGO stages IA, IB1, and IIA), or primary radiotherapy with concurrent administration of platinum-based chemotherapy (CRT) for patients with bulky FIGO stage IB2/ IIA2 tumors (> 4 cm) or locally advanced disease (FIGO stage IIB or greater). Some authors suggested the use of CRT followed by surgery for bulky tumors or locally advanced disease (1). Others proposed resection of the Müllerian compartment (fallopian tubes, uterus, proximal and middle vagina, enveloped by peritoneal and subperitoneal mesotissue known as mesometrium) and pelvic lymph node dissection by total mesometrial resection, without adjuvant radiation in FIGO stages IB, IIA, and selected IIB (2), following their ontogenetic theory of locoregional cancer spread (3-6). In all cases, pretreatment assessment of tumor extension and presence of parametrial invasion are of paramount importance to help define an appropriate management strategy. Staging of cervical cancer is still based on FIGO criteria, which are based on clinical findings. Its accuracy is limited in the advanced stages (7). Magnetic resonance imaging (MRI) has been shown to be the most reliable imaging technique in local staging, treatment planning, and follow-up of cervical cancer (8, 9), with staging accuracy ranging from 75% to 96% (10). In 2010, National Comprehensive Cancer Network (NCCN-2010) included MRI in the basic work-up of patients suffering from cervical cancer for stages greater than IB1.The aim of this paper is to show MRI anatomy of the parametrium, paying special attention to the pelvic landmarks, using a series of T2-weighted and diffusion-weighted imaging (DWI) findings that are useful to identify its complete extension (i.e., anterior and posterior extensions, in addition to the lateral extension). Technical suggestionsThe MRI protocol for cervical cancer usually includes anatomical and morphologic sequences of the pelvis, such as T1-weighted imaging in the axial plane and T2-weighted imaging in the axial and sagittal planes, and high spatial resolution axial oblique (short axis of cervix) and coronal oblique (long axis of cervix) T2-weighted imaging with small fieldof-view, which improve identification of parametrial invasion (12). Large field-of-view axial T1-and/or T2-weighted imaging of the abdomen is applied to identify enlarged lymph nodes and hydronephrosis. Dynamic multiphase contrast-enhanced three-dimensional T1-weighted imaging sequence is not routinely used for staging cervical carcinoma, unless the tumor is small and the patient is considered for fertility-sparing surgery or to distinguish ABSTRACTThis paper highlights an updated anatomy of parametrial extension with emphasis on magnetic resonance imaging (MRI) assessment of disease spread in the parametrium in patients with locally advanced cer...

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“…Hastalara yeterli barsak temizliği sonrasında boş mesane ile supin pozisyonunda görüntüleme yapılması hareket ve hayalet artefaktlarını azaltmaktadır [7]. Doğru tanımlama yapılması için uygun protokolü belirlemek gerekmektedir.…”

Section: Manyetik Rezonans Görüntülemeunclassified

Endometrium ve Serviks Kanserlerinde Görüntüleme

Öztürker¹,

Sönmez²

2015

Trd Sem

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MRI of Malignant Neoplasms of the Uterine Corpus and Cervix

Cited by 257 publications

References 72 publications

MR Imaging for Staging of Cervical Carcinoma: Update

MR Imaging for Staging of Cervical Carcinoma: Update

MRI anatomy of parametrial extension to better identify local pathways of disease spread in cervical cancer

Endometrium ve Serviks Kanserlerinde Görüntüleme

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