CT Abdomen and Pelvis With IV Contrast CT abdomen and pelvis with IV contrast may be used for the assessment of nodal and distant metastatic disease. Reported rates of unsuspected metastatic disease at a diagnosis range from 6.2% in a study of 1,158 consecutively evaluated cervical cancer patients to 13.7% in a study of patients with stage IB2 or greater disease on local Follow-up of Invasive Cancer of the Cervix assessment. The other most common sites of metastatic disease are in the lung, peritoneum, supraclavicular lymph nodes, liver, and bone [33-35]. With regards to nodal disease assessment, a meta-analysis of 115 studies published from 2000 to 2019 showed contrast-enhanced CT demonstrated good, although slightly inferior performance, compared to MRI and PET, with a pooled sensitivity and specificity of 51% (95% CI, 36%-67%) and 87% (95% CI, 81%-92%), compared to 57% (95% CI, 49%-64%) and 93% (95% CI, 89%-95%) for MRI, and 57% (95% CI, 48%-65%) and 95% (95% CI, 93%-97%) for PET [12]. Another meta-analysis of 72 studies found similar results with CT demonstrating a pooled sensitivity of 58% and a specificity of 92%, compared to 56% and 93% for MRI and 75% and 98% for PET [36]. These differences in performance are likely accounted for by difficulty in detecting disease in nodes <1 cm in size, for which MRI or PET are more sensitive. CT Abdomen and Pelvis Without and With IV Contrast The addition of noncontrast CT abdomen and pelvis images would not appreciably add to the contrast-enhanced CT evaluation. CT Abdomen and Pelvis Without IV Contrast CT abdomen and pelvis without IV contrast provides very poor soft tissue characterization in the pelvis [13] and therefore is not useful for the evaluation of invasive cervical cancer.
Pretreatment Evaluation and Follow up of Invasive Cancer of the Cervix. CT Abdomen and Pelvis With IV Contrast CT abdomen and pelvis with IV contrast may be used for the assessment of nodal and distant metastatic disease. Reported rates of unsuspected metastatic disease at a diagnosis range from 6.2% in a study of 1,158 consecutively evaluated cervical cancer patients to 13.7% in a study of patients with stage IB2 or greater disease on local Follow-up of Invasive Cancer of the Cervix assessment. The other most common sites of metastatic disease are in the lung, peritoneum, supraclavicular lymph nodes, liver, and bone [33-35]. With regards to nodal disease assessment, a meta-analysis of 115 studies published from 2000 to 2019 showed contrast-enhanced CT demonstrated good, although slightly inferior performance, compared to MRI and PET, with a pooled sensitivity and specificity of 51% (95% CI, 36%-67%) and 87% (95% CI, 81%-92%), compared to 57% (95% CI, 49%-64%) and 93% (95% CI, 89%-95%) for MRI, and 57% (95% CI, 48%-65%) and 95% (95% CI, 93%-97%) for PET [12]. Another meta-analysis of 72 studies found similar results with CT demonstrating a pooled sensitivity of 58% and a specificity of 92%, compared to 56% and 93% for MRI and 75% and 98% for PET [36]. These differences in performance are likely accounted for by difficulty in detecting disease in nodes <1 cm in size, for which MRI or PET are more sensitive. CT Abdomen and Pelvis Without and With IV Contrast The addition of noncontrast CT abdomen and pelvis images would not appreciably add to the contrast-enhanced CT evaluation. CT Abdomen and Pelvis Without IV Contrast CT abdomen and pelvis without IV contrast provides very poor soft tissue characterization in the pelvis [13] and therefore is not useful for the evaluation of invasive cervical cancer.