In a prospective case control study with 45 patients, SUVmax was an independent predictor of progression-free survival [53]. In addition, MTV and minimum ADC helped predict progression-free survival in stage I and II disease. Although both FDG-PET and MRI are shown to have utility in response assessment of patients with cervical cancer, additional research is needed to assess the utility of FDG-PET/MRI in these patients. MRI Abdomen Without and With IV Contrast MRI abdomen without and with IV contrast is not useful for the evaluation of initial treatment response assessment of primary cervical cancer after chemoradiation; however, it may be used for response assessment of distant metastatic disease [37]. If there is distant metastatic disease, imaging of the chest, abdomen, and pelvis is concurrently performed. MRI Abdomen Without IV Contrast MRI abdomen without IV contrast is not useful for the evaluation of initial treatment response assessment of primary cervical cancer after chemoradiation; however, it may be used for response assessment of distant metastatic disease [37]. If there is distant metastatic disease, imaging of the chest, abdomen, and pelvis is concurrently performed. MRI Pelvis Without and With IV Contrast MRI pelvis without and with IV contrast has a role in assessment of response of cervical cancer after chemoradiation. Given its excellent soft tissue contrast, MRI allows excellent visualization of tumor and allows serial volume measurements as well as early assessment of therapy failure by demonstrating increase in size [54]. Response to treatment results in fibrotic change, and reconstitution of normal low T2 signal of the cervical stroma is the most reliable indicator of complete response to radiation therapy [54,55]. Residual or refractory disease has intermediate T2 signal and restricted diffusion. MRI also has a likely role in patients with early-stage cervical cancer following conization.
Pretreatment Evaluation and Follow up of Invasive Cancer of the Cervix. In a prospective case control study with 45 patients, SUVmax was an independent predictor of progression-free survival [53]. In addition, MTV and minimum ADC helped predict progression-free survival in stage I and II disease. Although both FDG-PET and MRI are shown to have utility in response assessment of patients with cervical cancer, additional research is needed to assess the utility of FDG-PET/MRI in these patients. MRI Abdomen Without and With IV Contrast MRI abdomen without and with IV contrast is not useful for the evaluation of initial treatment response assessment of primary cervical cancer after chemoradiation; however, it may be used for response assessment of distant metastatic disease [37]. If there is distant metastatic disease, imaging of the chest, abdomen, and pelvis is concurrently performed. MRI Abdomen Without IV Contrast MRI abdomen without IV contrast is not useful for the evaluation of initial treatment response assessment of primary cervical cancer after chemoradiation; however, it may be used for response assessment of distant metastatic disease [37]. If there is distant metastatic disease, imaging of the chest, abdomen, and pelvis is concurrently performed. MRI Pelvis Without and With IV Contrast MRI pelvis without and with IV contrast has a role in assessment of response of cervical cancer after chemoradiation. Given its excellent soft tissue contrast, MRI allows excellent visualization of tumor and allows serial volume measurements as well as early assessment of therapy failure by demonstrating increase in size [54]. Response to treatment results in fibrotic change, and reconstitution of normal low T2 signal of the cervical stroma is the most reliable indicator of complete response to radiation therapy [54,55]. Residual or refractory disease has intermediate T2 signal and restricted diffusion. MRI also has a likely role in patients with early-stage cervical cancer following conization.