Nodal metastases may be detected on a noncontrast-enhanced examination based on an abnormal size of >0.8 cm in axial short axis in the pelvis or >1 cm in axial short axis in the abdomen, an abnormally rounded shape, or loss of the normal fatty hilum. However, sensitivity may be decreased because of the difficulties distinguishing lymph nodes from adjacent vessels and/or small bowel loops. CT Chest With IV Contrast Evaluation of the chest for metastatic disease is critical for patients with stage IB2 or greater disease because the rate of occult metastases is as high as 38% in this population [33]. Given its superior diagnostic performance for the detection of small pulmonary nodules, chest CT is preferred to chest radiography for this purpose. Although IV contrast is not necessary for the evaluation of the lung parenchyma and pleural spaces, it is strongly preferred for the detection of abdominopelvic metastases. Therefore, CT chest with IV contrast is commonly performed along with the abdomen and pelvis examination. CT Chest Without and With IV Contrast The addition of noncontrast CT chest images would not appreciably add to the contrast-enhanced CT evaluation. CT Chest Without IV Contrast Evaluation of the chest for metastatic disease is critical for patients with stage IB2 or greater disease because the rate of occult metastases is as high as 38% in this population [33]. Given its superior diagnostic performance for the detection of small pulmonary nodules, chest CT is preferred to chest radiography for this purpose. FDG-PET/CT Skull Base to Mid-Thigh PET/CT is the current modality of choice for assessment for nodal and distant metastatic disease. The National Comprehensive Cancer Network (NCCN) guidelines recommend a PET/CT be performed at the time of initial staging for all patients with stage IB2 disease or greater, given a rate of unsuspected distant metastatic disease of 13.7% in this population [33,37].
Pretreatment Evaluation and Follow up of Invasive Cancer of the Cervix. Nodal metastases may be detected on a noncontrast-enhanced examination based on an abnormal size of >0.8 cm in axial short axis in the pelvis or >1 cm in axial short axis in the abdomen, an abnormally rounded shape, or loss of the normal fatty hilum. However, sensitivity may be decreased because of the difficulties distinguishing lymph nodes from adjacent vessels and/or small bowel loops. CT Chest With IV Contrast Evaluation of the chest for metastatic disease is critical for patients with stage IB2 or greater disease because the rate of occult metastases is as high as 38% in this population [33]. Given its superior diagnostic performance for the detection of small pulmonary nodules, chest CT is preferred to chest radiography for this purpose. Although IV contrast is not necessary for the evaluation of the lung parenchyma and pleural spaces, it is strongly preferred for the detection of abdominopelvic metastases. Therefore, CT chest with IV contrast is commonly performed along with the abdomen and pelvis examination. CT Chest Without and With IV Contrast The addition of noncontrast CT chest images would not appreciably add to the contrast-enhanced CT evaluation. CT Chest Without IV Contrast Evaluation of the chest for metastatic disease is critical for patients with stage IB2 or greater disease because the rate of occult metastases is as high as 38% in this population [33]. Given its superior diagnostic performance for the detection of small pulmonary nodules, chest CT is preferred to chest radiography for this purpose. FDG-PET/CT Skull Base to Mid-Thigh PET/CT is the current modality of choice for assessment for nodal and distant metastatic disease. The National Comprehensive Cancer Network (NCCN) guidelines recommend a PET/CT be performed at the time of initial staging for all patients with stage IB2 disease or greater, given a rate of unsuspected distant metastatic disease of 13.7% in this population [33,37].