Considering local invasion, a study of 33 patients who underwent pretreatment PET/MRI showed a higher area under the curve than MRI alone for the detection of parametrial invasion (0.89 versus 0.73), vaginal invasion (85% versus 74%), and deep cervical stromal invasion (96% versus 74%) [15]. In addition to the staging evaluation, PET/MRI offers prognostic information with a higher maximum standardized uptake value (SUVmax) associated with poorer prognosis [16,17] and was found to be an independent predictor of progression-free survival (hazard radio [HR] = 4.57). MRI Pelvis Without and With IV Contrast MRI is used to determine invasive cervical cancer tumor size and the extent of local invasion. Its superior soft tissue characterization allows for a more accurate staging assessment than can be obtained by CT or ultrasound (US) [11,18-20]. T2-weighted noncontrast sequences in the sagittal plane, axial oblique plane through the axis of the cervix, and coronal oblique planes though the axis of the cervix are the foundations of the anatomic assessment [21,22]. One prospective study of 100 patients with prehysterectomy MRIs showed 86% agreement between MRI and surgical pathologic findings for tumor size and local extent evaluation (95% CI, 76.3%-90.9%) [23]. Another meta- MRI Pelvis Without IV Contrast Although IV contrast administration is preferred, MRI pelvis without IV contrast may improve the conspicuity of small lesions compared with other imaging modalities [27,28] and may help to distinguish between cervical and endometrial primaries when the tumor involves both anatomic regions [29]. The T2-weighted noncontrast sequences in the sagittal plane, axial oblique plane through the axis of the cervix, and coronal oblique planes though the axis of the cervix are the foundations of the anatomic assessment [21,22], and the DWI/ADC images may help to detect small lesions.
Pretreatment Evaluation and Follow up of Invasive Cancer of the Cervix. Considering local invasion, a study of 33 patients who underwent pretreatment PET/MRI showed a higher area under the curve than MRI alone for the detection of parametrial invasion (0.89 versus 0.73), vaginal invasion (85% versus 74%), and deep cervical stromal invasion (96% versus 74%) [15]. In addition to the staging evaluation, PET/MRI offers prognostic information with a higher maximum standardized uptake value (SUVmax) associated with poorer prognosis [16,17] and was found to be an independent predictor of progression-free survival (hazard radio [HR] = 4.57). MRI Pelvis Without and With IV Contrast MRI is used to determine invasive cervical cancer tumor size and the extent of local invasion. Its superior soft tissue characterization allows for a more accurate staging assessment than can be obtained by CT or ultrasound (US) [11,18-20]. T2-weighted noncontrast sequences in the sagittal plane, axial oblique plane through the axis of the cervix, and coronal oblique planes though the axis of the cervix are the foundations of the anatomic assessment [21,22]. One prospective study of 100 patients with prehysterectomy MRIs showed 86% agreement between MRI and surgical pathologic findings for tumor size and local extent evaluation (95% CI, 76.3%-90.9%) [23]. Another meta- MRI Pelvis Without IV Contrast Although IV contrast administration is preferred, MRI pelvis without IV contrast may improve the conspicuity of small lesions compared with other imaging modalities [27,28] and may help to distinguish between cervical and endometrial primaries when the tumor involves both anatomic regions [29]. The T2-weighted noncontrast sequences in the sagittal plane, axial oblique plane through the axis of the cervix, and coronal oblique planes though the axis of the cervix are the foundations of the anatomic assessment [21,22], and the DWI/ADC images may help to detect small lesions.