New development of the FIGO staging system

Odicino, Franco; Miscioscia, Rebecca; Tisi, Giancarlo; Rampinelli, Fabio; Sartori, Enrico; Pecorelli, Sërgio

doi:10.1016/j.ygyno.2007.07.018

Cited by 10 publications

(6 citation statements)

References 5 publications

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“…Whereas the introduction of cervical cancer screening programs and improved treatment strategies have caused a reduction in mortality rates in industrialized nations, there has been little change in developing countries, where tumors are usually detected at an advanced stage. Because of its epidemiologic characteristics, cervical carcinoma continues to be staged at clinical examination, with anesthesia and often with cystoscopy and sigmoidoscopy, according to the FIGO classification system (55). However, there are discrepancies between tumors that are staged at clinical examination according to the FIGO staging system and those that are staged at surgery, with an error rate as high as 32% in patients with stage IB disease and 65% in patients with stage III disease (13).…”

Section: Cervical Carcinomamentioning

confidence: 99%

“…The revised FIGO staging system for cervical carcinoma was implemented on June 1, 2009 (Table 6). In the new FIGO staging system, the following three changes, which affect imaging and interpretation, were made: First, the use of diagnostic imaging, including CT and MR imaging, to stage cervical tumors is recommended but remains nonmandatory (55). CT is able to depict lymph nodes, hydronephrosis, and distant metastases.…”

Section: Revised Figo Stagingmentioning

confidence: 99%

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The Revised FIGO Staging System for Uterine Malignancies: Implications for MR Imaging

Freeman

Aly²,

Kataoka³

et al. 2012

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Cancers of the uterine corpus and cervix are the most common gynecologic malignancies worldwide. The International Federation of Gynecology and Obstetrics (FIGO) staging system was first established in 1958, when it was recognized that the recurrence rate and patient outcomes were directly related to the degree of tumor spread at the patient's initial presentation. Changes in understanding of tumor biology led to a recent update in the FIGO staging system that reflects the variation in treatment strategies between endometrial and cervical cancer. Patients with endometrial cancer are primarily treated with hysterectomy; thus, staging is done at surgery and histologic analysis. Magnetic resonance (MR) imaging may accurately depict the extent of endometrial cancer at diagnosis and, in conjunction with the tumor grade and histologic subtype, help stratify risk, which determines the therapeutic course. Cervical carcinoma is staged at clinical examination because many tumors are inoperable at the time of patient presentation. Preoperative MR imaging criteria are not formally included in the revised FIGO staging system because cervical carcinoma is most prevalent in developing countries, where imaging resources are limited. However, MR imaging is highly sensitive and specific for depicting important prognostic factors and, when available, is recommended as an adjunct to clinical examination. The MR imaging findings of uterine carcinoma should be discussed in a multidisciplinary setting in conjunction with clinical and histologic findings, an approach that provides accurate staging and risk stratification and allows for individualized treatment.

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Section: Cervical Carcinomamentioning

confidence: 99%

Section: Revised Figo Stagingmentioning

confidence: 99%

The Revised FIGO Staging System for Uterine Malignancies: Implications for MR Imaging

Freeman

Aly²,

Kataoka³

et al. 2012

RadioGraphics

171

119

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“…Following the 2009 FIGO update, and supported by (inter)national guidelines, magnetic resonance imaging (MRI) may be added to the work-up to assist clinical staging [5–7]. A meta-analysis ( n = 3,254, 40 studies) showed a pooled sensitivity of 84 % for detection of parametrial invasion by MRI, substantially superior to the 40 % achieved by clinical examination [8].…”

Section: Introductionmentioning

confidence: 99%

High-resolution T2-weighted cervical cancer imaging: a feasibility study on ultra-high-field 7.0-T MRI with an endorectal monopole antenna

et al. 2016

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ObjectivesWe studied the feasibility of high-resolution T2-weighted cervical cancer imaging on an ultra-high-field 7.0-T magnetic resonance imaging (MRI) system using an endorectal antenna of 4.7-mm thickness.MethodsA feasibility study on 20 stage IB1–IIB cervical cancer patients was conducted. All underwent pre-treatment 1.5-T MRI. At 7.0-T MRI, an external transmit/receive array with seven dipole antennae and a single endorectal monopole receive antenna were used. Discomfort levels were assessed. Following individualised phase-based B1 + shimming, T2-weighted turbo spin echo sequences were completed.ResultsPatients had stage IB1 (n = 9), IB2 (n = 4), IIA1 (n = 1) or IIB (n = 6) cervical cancer. Discomfort (ten-point scale) was minimal at placement and removal of the endorectal antenna with a median score of 1 (range, 0–5) and 0 (range, 0–2) respectively. Its use did not result in adverse events or pre-term session discontinuation. To demonstrate feasibility, T2-weighted acquisitions from 7.0-T MRI are presented in comparison to 1.5-T MRI. Artefacts on 7.0-T MRI were due to motion, locally destructive B1 interference, excessive B1 under the external antennae and SENSE reconstruction.ConclusionsHigh-resolution T2-weighted 7.0-T MRI of stage IB1–IIB cervical cancer is feasible. The addition of an endorectal antenna is well tolerated by patients.Key Points• High resolution T 2-weighted 7.0-T MRI of the inner female pelvis is challenging • We demonstrate a feasible approach for T 2-weighted 7.0-T MRI of cervical cancer • An endorectal monopole receive antenna is well tolerated by participants • The endorectal antenna did not lead to adverse events or session discontinuation Electronic supplementary materialThe online version of this article (doi:10.1007/s00330-016-4419-y) contains supplementary material, which is available to authorized users.

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“…Nearly 80% of cervical cancer occurs in the developing countries and most patients are diagnosed with the disease at an advanced stage, thus not suitable for surgical staging. Therefore cervical cancer usually remains a clinically staged disease [2]. However, there are significant inaccuracies in the clinical staging system compared to surgical staging, with an error rate up to 32% in patients with stage IB disease and up to 65% of patients with stage III disease [3].…”

Section: Introductionmentioning

confidence: 99%

Staging of uterine cervical cancer with MRI: guidelines of the European Society of Urogenital Radiology

Balleyguier

Sala

Cunha³

et al. 2010

Eur Radiol

269

199

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Objective: To design clear guidelines for the staging and follow-up of patients with uterine cervical cancer, and to provide the radiologist with a framework for use in multidisciplinary conferences. Methods: Guidelines for uterine cervical cancer staging and follow-up were defined by the female imaging subcommittee of the ESUR (European Society of Urogenital Radiology) based on the expert consensus of imaging protocols of 11 leading institutions and a critical review of the literature. Results: The results indicated that high field Magnetic Resonance Imaging (MRI) should include at least two T2-weighted sequences in sagittal, axial oblique or coronal oblique

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New development of the FIGO staging system

Cited by 10 publications

References 5 publications

The Revised FIGO Staging System for Uterine Malignancies: Implications for MR Imaging

The Revised FIGO Staging System for Uterine Malignancies: Implications for MR Imaging

High-resolution T2-weighted cervical cancer imaging: a feasibility study on ultra-high-field 7.0-T MRI with an endorectal monopole antenna

Staging of uterine cervical cancer with MRI: guidelines of the European Society of Urogenital Radiology

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