In a retrospective study with 102 patients, tumors with infiltrative growth pattern on MRI were associated with a lower overall and locoregional recurrence-free survival rates after chemoradiation [66]. Additional studies and a meta-analysis have also indicated that MRI features, including ADC value and tumor volume, of primary cervical cancer as well as nodal disease can help predict Follow-up of Invasive Cancer of the Cervix metastasis-free and overall survival rates [77-81]. These findings may influence the surveillance strategy of patients with cervical cancer. 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 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 with IV contrast 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 with IV contrast should be considered 3 to 6 months after completion of therapy [37]. MRI Pelvis Without IV Contrast MRI pelvis with IV contrast is the preferred study, but without IV contrast may also be useful. In a retrospective study of 103 patients with stage IB-IVA cervical cancer, the smaller increase in ADC values and the smaller decrease in tumor volume during chemoradiation or radiation treatment were predictors of tumor recurrence over a median follow-up period of 2.7 years [77]. Additional studies have also indicated that MRI features, including ADC value and tumor volume, of primary cervical cancer as well as nodal disease can help predict metastasis-free and overall survival rates [77-80]. These findings may influence the surveillance strategy of patients with cervical cancer.
Pretreatment Evaluation and Follow up of Invasive Cancer of the Cervix. In a retrospective study with 102 patients, tumors with infiltrative growth pattern on MRI were associated with a lower overall and locoregional recurrence-free survival rates after chemoradiation [66]. Additional studies and a meta-analysis have also indicated that MRI features, including ADC value and tumor volume, of primary cervical cancer as well as nodal disease can help predict Follow-up of Invasive Cancer of the Cervix metastasis-free and overall survival rates [77-81]. These findings may influence the surveillance strategy of patients with cervical cancer. 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 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 with IV contrast 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 with IV contrast should be considered 3 to 6 months after completion of therapy [37]. MRI Pelvis Without IV Contrast MRI pelvis with IV contrast is the preferred study, but without IV contrast may also be useful. In a retrospective study of 103 patients with stage IB-IVA cervical cancer, the smaller increase in ADC values and the smaller decrease in tumor volume during chemoradiation or radiation treatment were predictors of tumor recurrence over a median follow-up period of 2.7 years [77]. Additional studies have also indicated that MRI features, including ADC value and tumor volume, of primary cervical cancer as well as nodal disease can help predict metastasis-free and overall survival rates [77-80]. These findings may influence the surveillance strategy of patients with cervical cancer.