Radiography Chest Chest radiography is not useful for the evaluation of initial treatment response assessment of primary cervical cancer after chemoradiation; however, it may be used for detection of distant metastatic disease [37]. US Abdomen Abdominal US is not useful for the evaluation of initial treatment response assessment of primary cervical cancer after chemoradiation. US Pelvis Transabdominal There is no relevant literature to support the use of transabdominal pelvic US for the evaluation of initial treatment response assessment of primary cervical cancer after chemoradiation. US Pelvis Transvaginal In a prospective study of 128 women, TVUS showed an overall 92% accuracy in predicting response to chemotherapy, with decreased tumor volume being the most important association of response [67]. In another retrospective study of 51 patients, TVUS had a high sensitivity and specificity in identifying persistent parametrial invasion after neoadjuvant chemotherapy [68]. Another prospective study with 88 patients showed that after 2 weeks of neoadjuvant treatment, TVUS was able to demonstrate higher tumor volume in patients with partial response compared to those with complete response [69]. In the same study, additional color Doppler and contrast features was also significantly different in the partial- and complete-response groups, both before and after 2 weeks of treatment; however, the sensitivity (48%-77%) and specificity (58%-84%) of various US parameters were not high enough for accurate prospective prediction of treatment response [69]. Follow-up of Invasive Cancer of the Cervix Variant 4: Surveillance of treated cervical cancer in asymptomatic patients. Recurrent cervical cancer is defined as local regrowth of tumor, presence of distant metastases, or a combination of both 6 months after the completion of treatment.
Pretreatment Evaluation and Follow up of Invasive Cancer of the Cervix. Radiography Chest Chest radiography is not useful for the evaluation of initial treatment response assessment of primary cervical cancer after chemoradiation; however, it may be used for detection of distant metastatic disease [37]. US Abdomen Abdominal US is not useful for the evaluation of initial treatment response assessment of primary cervical cancer after chemoradiation. US Pelvis Transabdominal There is no relevant literature to support the use of transabdominal pelvic US for the evaluation of initial treatment response assessment of primary cervical cancer after chemoradiation. US Pelvis Transvaginal In a prospective study of 128 women, TVUS showed an overall 92% accuracy in predicting response to chemotherapy, with decreased tumor volume being the most important association of response [67]. In another retrospective study of 51 patients, TVUS had a high sensitivity and specificity in identifying persistent parametrial invasion after neoadjuvant chemotherapy [68]. Another prospective study with 88 patients showed that after 2 weeks of neoadjuvant treatment, TVUS was able to demonstrate higher tumor volume in patients with partial response compared to those with complete response [69]. In the same study, additional color Doppler and contrast features was also significantly different in the partial- and complete-response groups, both before and after 2 weeks of treatment; however, the sensitivity (48%-77%) and specificity (58%-84%) of various US parameters were not high enough for accurate prospective prediction of treatment response [69]. Follow-up of Invasive Cancer of the Cervix Variant 4: Surveillance of treated cervical cancer in asymptomatic patients. Recurrent cervical cancer is defined as local regrowth of tumor, presence of distant metastases, or a combination of both 6 months after the completion of treatment.