ARRS 2022 Abstracts


E1998. Cervical Cancer Imaging: What the Radiologist Needs to Know
  1. Gayathri Sivagurunathan; Royal Lancaster Infirmary
  2. Melanie Schofield; Royal Lancaster Infirmary
  3. Ranjan Kukreti; Furness General Hospital
Cervical cancer is the fourth most common cancer in women worldwide. The International Federation of Gynecology and Obstetrics (FIGO) is a widely used staging system for cervical cancer based on clinical examination. In 2018, imaging and pathology findings were used in this system for staging. Imaging plays an important role for accurate staging, and MRI is the modality of choice for local staging and PET/CT is used for distant metastasis.

Educational Goals / Teaching Points
This exhibit aims to describe the anatomy of the uterine cervix and its normal MRI appearance; explain the MRI imaging protocol; describe FIGO staging of cervical cancer and corresponding MRI appearances; review indications for other imaging modalities for preoperative staging and follow up; and discuss imaging in recurrence.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
MRI is the modality of choice to assess local staging of cervical cancer and helps in treatment planning. Knowledge of MRI protocols, mainly T2-weighted and diffusion-weighted sequences, in assessing tumour size, nodal involvement, parametrial, vaginal involvement, pelvic side wall involvement, and bladder and rectal invasion are important for accurate staging. Understanding the usefulness and limitations of FDG PET/CT helps in recommending the modality appropriately. Knowledge of the prognostic factors and treatment options is important for radiologist to provide useful reports. Familiarity with imaging appearances after treatment and in recurrence helps the radiologist identify the disease early, thereby ensuring appropriate treatment.

Knowledge of MRI of the uterine cervix, FIGO staging, prognostic factors, treatment options, and post-treatment follow-up and recurrence imaging are important for the radiologist to understand the disease process and to stage the tumor accurately for appropriate management.