Review
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Apr 28, 2016; 8(4): 342-354
Published online Apr 28, 2016. doi: 10.4329/wjr.v8.i4.342
Current imaging strategies for the evaluation of uterine cervical cancer
Charis Bourgioti, Konstantinos Chatoupis, Lia Angela Moulopoulos
Charis Bourgioti, Konstantinos Chatoupis, Lia Angela Moulopoulos, Department of Radiology, School of Medicine, National and Kapodistrian University of Athens, Aretaieion Hospital, 11528 Athens, Greece
Author contributions: All authors equally contributed to the conception and design of the study and acquisition of data; all authors participated in drafting the article; all authors approved the final draft of the article.
Conflict-of-interest statement: No potential conflicts of interest. No financial support.
Open-Access: This article is an open-access article which was selected byan in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Charis Bourgioti, MD, Department of Radiology, School of Medicine, National and Kapodistrian University of Athens, Aretaieion Hospital, 76 Vas. Sofias Ave., 11528 Athens, Greece. charisbourgioti@yahoo.com
Telephone: +30-210-7286246 Fax: +30-210-7220253
Received: September 27, 2015
Peer-review started: October 5, 2015
First decision: December 28, 2015
Revised: January 15, 2016
Accepted: January 28, 2016
Article in press: January 31, 2016
Published online: April 28, 2016
Processing time: 204 Days and 21.4 Hours
Abstract

Uterine cervical cancer still remains an important socioeconomic issue because it largely affects women of reproductive age. Prognosis is highly depended on extent of the disease at diagnosis and, therefore, accurate staging is crucial for optimal management. Cervical cancer is clinically staged, according to International Federation of Gynecology and Obstetrics guidelines, but, currently, there is increased use of cross sectional imaging modalities [computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography-CT (PET-CT)] for the study of important prognostic factors like tumor size, parametrial invasion, endocervical extension, pelvic side wall or adjacent/distal organs involvement and lymph node status. Imaging indications also include cervical cancer follow-up, evaluation of tumor response to treatment and selection of suitable candidates for less radical surgeries like radical trachelectomy for fertility preservation. The preferred imaging method for local cervical cancer evaluation is MRI; CT is equally effective for evaluation of extrauterine spread of the disease. PET-CT shows high diagnostic performance for the detection of tumor relapse and metastatic lymph nodes. The aim of this review is to familiarize radiologists with the MRI appearance of cervical carcinoma and to discuss the indications of cross sectional imaging during the course of the disease in patients with cervical carcinoma.

Keywords: Cervical cancer; Computed tomography; Positron emission tomography/computed tomography; Magnetic resonance imaging; Tumor staging

Core tip: Although cervical cancer staging is based on clinical assessment, there is a wide use of cross sectional imaging [magnetic resonance imaging, computed tomography (CT), positron emission tomography-CT] in the pre- and post-treatment work up of these patients. Imaging may provide important information for the discrimination between operable and advanced cervical cancer, the evaluation of tumor response to therapy and the detection of recurrent disease. The aim of this study is to summarize current literature data regarding the use of imaging in cervical carcinoma evaluation and to familiarize radiologists with the available imaging techniques and the corresponding imaging features of cervical tumors.