PET/MR Imaging for the Evaluation of Cervical Cancer During Pregnancy

Abstract

Background: To assess the diagnostic value of positron emission tomography/magnetic resonance imaging (PET/MRI) for cervical cancer propagation before surgery, especially in pregnant women.Methods: 18F Fluorodeoxyglucose (FDG)-PET/MRI was performed in seven pregnant cervical cancer patients (28 - 34 years old) at 9-18 gestational weeks. In case #5, a second PET/MRI was performed at 24 gestational weeks. Results: Of seven FDG-PET/MRI examination series in six cases (cases #1-#6), FDG-PET/MR imaging could detect cervical tumors with abnormal FDG accumulation; these tumors were confirmed with a standardized uptake value max (SUV max) titer of 4.5 - 16. A second PET/MRI examination in case #5 revealed the same SUV max titer as the first examination. In these six imaging series (cases #1-#5), there were no signs of cancer metastasis to the parametrium and lymph nodes. However, in case #6, abnormal FDG accumulation in the left parametrial lymph nodes was also detectable. Pathological examination showed lymph node metastasis in case #6. In case #7, PET/MRI could not detect any abnormal FDG accumulation in the cervix and other sites. Cone biopsy demonstrated only micro-invasive squamous cell carcinoma. After treatment for cervical cancer, all seven patients have had no recurrence of disease within the follow-up period (2.4 – 5.2 years), and their children have developed appropriately.Conclusion: PET/MRI is an effective and relatively safe imaging tool to evaluate cervical cancer progression in pregnancy.

Effectiveness of visual inspection of Acetic Acid (VIA) and Pap Smear in cervical cancer screening: Literature review

“…Squamous epithelial cell-derived cancer of the cervix is a malignant tumor (Nindrea, 2017). Most cervical cancers are caused by high-risk human papillomavirus (HPV) infection, making it one of the most common gynecologic cancers (Ishiguro et al, 2021). Cervical disease is the second most normal malignant growth among ladies worldwide, with an expected 528,000 cases and 260,000 passings yearly (Kagabu et al, 2020).…”