What Is the Role of Imaging at Primary Diagnostic Work-Up in Uterine Cervical Cancer?

Ingfrid S. Haldorsen*, Njal Lura, Jan Blaakaer, Daniela Fischerova, Henrica M. J. Werner

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

27 Citations (Web of Science)

Abstract

Purpose of ReviewFor uterine cervical cancer, the recently revised International Federation of Gynecology and Obstetrics (FIGO) staging system (2018) incorporates imaging and pathology assessments in its staging. In this review we summarize the reported staging performances of conventional and novel imaging methods and provide an overview of promising novel imaging methods relevant for cervical cancer patient care.Recent FindingsDiagnostic imaging during the primary diagnostic work-up is recommended to better assess tumor extent and metastatic disease and is now reflected in the 2018 FIGO stages 3C1 and 3C2 (positive pelvic and/or paraaortic lymph nodes). For pretreatment local staging, imaging by transvaginal or transrectal ultrasound (TVS, TRS) and/or magnetic resonance imaging (MRI) is instrumental to define pelvic tumor extent, including a more accurate assessment of tumor size, stromal invasion depth, and parametrial invasion. In locally advanced cervical cancer, positron emission tomography-computed tomography (PET-CT) or computed tomography (CT) is recommended, since the identification of metastatic lymph nodes and distant metastases has therapeutic consequences. Furthermore, novel imaging techniques offer visualization of microstructural and functional tumor characteristics, reportedly linked to clinical phenotype, thus with a potential for further improving risk stratification and individualization of treatment.SummaryDiagnostic imaging by MRI/TVS/TRS and PET-CT/CT is instrumental for pretreatment staging in uterine cervical cancer and guides optimal treatment strategy. Novel imaging techniques may also provide functional biomarkers with potential relevance for developing more targeted treatment strategies in cervical cancer.

Original languageEnglish
Article number77
Number of pages15
JournalCurrent Oncology Reports
Volume21
Issue number9
DOIs
Publication statusPublished - Sep 2019

Keywords

  • Cervical cancer
  • Transvaginal ultrasound
  • Magnetic resonance imaging
  • Diffusion-weighted imaging
  • Positron emission tomography
  • Imaging biomarkers
  • APPARENT DIFFUSION-COEFFICIENT
  • CONTRAST-ENHANCED MRI
  • PREDICTING PARAMETRIAL INVASION
  • LYMPH-NODE METASTASES
  • EARLY-STAGE
  • CONCURRENT CHEMORADIOTHERAPY
  • INTERNATIONAL FEDERATION
  • TRANSRECTAL ULTRASOUND
  • RADICAL HYSTERECTOMY
  • RADIATION-THERAPY

Cite this