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 the degree of clinical concern, such as clinical examination findings or pelvic, abdominal, or pulmonary symptoms [37]. Stage IB3 patients of those with risk factors such as positive nodes, parametrial extension. or positive margins may undergo PET/CT at 3 to 6 months after completion of treatment [37]. Generally, NCCN guidelines recommend the use of PET/CT over CT for the evaluation of metastatic disease [37]. FDG-PET/MRI Skull Base to Mid-Thigh In a prospective study of 45 patients with newly diagnosed cervical cancer, an SUVmax was an independent predictor of progression-free survival (HR = 4.57, P < . 05). Minimum ADC was an independent predictor of overall survival [53]. Additional studies have indicated that metabolic parameters including SUVmax, MTV, and TLG may help predict outcomes including overall survival [49,73,74]. A retrospective study on 31 patients found PET/MRI to be useful in assessment of recurrent and metastatic disease and also found that that was a significant inverse correlation between SUVmax and ADC values [75]. Another small prospective study showed that PET/MRI was able to detect both local and distant recurrence of cervical cancer and found a similar significant inverse correlation between SUVmax and ADC values [76]. MRI Abdomen Without and With IV Contrast At present there is no relevant literature to support the use of MRI abdomen without and with IV contrast for surveillance of patients with asymptomatic cervical cancer [37]. For stage II to IV patients, NCCN guidelines recommend PET/CT (preferred) or CT of the chest, abdomen, and pelvis [37]. Imaging of the chest, abdomen, and pelvis is often concurrently performed.
Pretreatment Evaluation and Follow up of Invasive Cancer of the Cervix. 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 the degree of clinical concern, such as clinical examination findings or pelvic, abdominal, or pulmonary symptoms [37]. Stage IB3 patients of those with risk factors such as positive nodes, parametrial extension. or positive margins may undergo PET/CT at 3 to 6 months after completion of treatment [37]. Generally, NCCN guidelines recommend the use of PET/CT over CT for the evaluation of metastatic disease [37]. FDG-PET/MRI Skull Base to Mid-Thigh In a prospective study of 45 patients with newly diagnosed cervical cancer, an SUVmax was an independent predictor of progression-free survival (HR = 4.57, P < . 05). Minimum ADC was an independent predictor of overall survival [53]. Additional studies have indicated that metabolic parameters including SUVmax, MTV, and TLG may help predict outcomes including overall survival [49,73,74]. A retrospective study on 31 patients found PET/MRI to be useful in assessment of recurrent and metastatic disease and also found that that was a significant inverse correlation between SUVmax and ADC values [75]. Another small prospective study showed that PET/MRI was able to detect both local and distant recurrence of cervical cancer and found a similar significant inverse correlation between SUVmax and ADC values [76]. MRI Abdomen Without and With IV Contrast At present there is no relevant literature to support the use of MRI abdomen without and with IV contrast for surveillance of patients with asymptomatic cervical cancer [37]. For stage II to IV patients, NCCN guidelines recommend PET/CT (preferred) or CT of the chest, abdomen, and pelvis [37]. Imaging of the chest, abdomen, and pelvis is often concurrently performed.