Per NCCN guidelines, for stage I patients who undergo nonfertility sparing treatment, the use of imaging for surveillance of cervical cancer in asymptomatic patients should be based on symptomatology and the degree of clinical concern, such as clinical examination findings or pelvic, abdominal, or pulmonary symptoms [37]. For stage I patients who undergo fertility sparing treatment, MRI may be performed at 3 to 6 months and then yearly for 2 to 3 years [37]. For stage II through IV patients, pelvic MRI should be considered at 3 to 6 months after completion of therapy [37]. IV contrast should be used unless contraindicated [37]. Radiography Chest There is no relevant literature to support the use of chest radiography in the surveillance of patients with cervical cancer [5,37]. US Abdomen There is no relevant literature to support the use of US abdomen in the surveillance of patients with cervical cancer [5,37]. US Pelvis Transabdominal There is no relevant literature to support the use of pelvic transabdominal US in the surveillance of patients with cervical cancer [5,37]. US Pelvis Transvaginal There is no relevant literature to support the use of pelvic TVUS in the surveillance of patients with cervical cancer [5,37]. Variant 5: Evaluation of known or suspected cervical cancer local recurrence or distant metastatic disease. Follow-up imaging. The majority of patients with recurrent cervical cancer are symptomatic, with the symptoms ranging from abdominal and pelvic pain, leg symptoms such as pain or lymphedema, vaginal bleeding or discharge, urinary symptoms, cough, and weight loss [5]. CT, MRI, and PET/CT all have a role in detection of local or distant recurrence in symptomatic patients, as well as in the response assessment after chemotherapy. CT Abdomen and Pelvis With IV Contrast CT may be used for the assessment of known distant recurrence, preferably with use of IV contrast [37].
Pretreatment Evaluation and Follow up of Invasive Cancer of the Cervix. Per NCCN guidelines, for stage I patients who undergo nonfertility sparing treatment, the use of imaging for surveillance of cervical cancer in asymptomatic patients should be based on symptomatology and the degree of clinical concern, such as clinical examination findings or pelvic, abdominal, or pulmonary symptoms [37]. For stage I patients who undergo fertility sparing treatment, MRI may be performed at 3 to 6 months and then yearly for 2 to 3 years [37]. For stage II through IV patients, pelvic MRI should be considered at 3 to 6 months after completion of therapy [37]. IV contrast should be used unless contraindicated [37]. Radiography Chest There is no relevant literature to support the use of chest radiography in the surveillance of patients with cervical cancer [5,37]. US Abdomen There is no relevant literature to support the use of US abdomen in the surveillance of patients with cervical cancer [5,37]. US Pelvis Transabdominal There is no relevant literature to support the use of pelvic transabdominal US in the surveillance of patients with cervical cancer [5,37]. US Pelvis Transvaginal There is no relevant literature to support the use of pelvic TVUS in the surveillance of patients with cervical cancer [5,37]. Variant 5: Evaluation of known or suspected cervical cancer local recurrence or distant metastatic disease. Follow-up imaging. The majority of patients with recurrent cervical cancer are symptomatic, with the symptoms ranging from abdominal and pelvic pain, leg symptoms such as pain or lymphedema, vaginal bleeding or discharge, urinary symptoms, cough, and weight loss [5]. CT, MRI, and PET/CT all have a role in detection of local or distant recurrence in symptomatic patients, as well as in the response assessment after chemotherapy. CT Abdomen and Pelvis With IV Contrast CT may be used for the assessment of known distant recurrence, preferably with use of IV contrast [37].