Revised FIGO Staging for Cervical Cancer – A New Role for MRI

Abstract

Cervical cancer is still the fourth most common malignancy in women worldwide and has a high mortality rate. The prognosis as well as the therapy depends largely on the extent of the tumor at the time of initial diagnosis. This shows the importance of correct staging of cervical cancer. In order to promote a globally uniform approach, staging of cervical cancer in the past was based on widespread examinations such as exam under anesthesia, histology from cervical conization or biopsy, systematic lymphadenectomy, cystoscopy, proctoscopy, i. v.-pyelogram and chest X-ray. However, as the primary tumor stage was often underestimated, the 2018 revised FIGO classification now permits cross-sectional imaging techniques and pathological findings to be incorporated into disease staging or an already existing stage to be adapted based on radiological findings. Thanks to its excellent soft tissue contrast, magnetic resonance imaging (MRI) is the method of choice for local-regional staging of cervical cancer, evaluating the response to treatment, detecting tumor recurrence and for follow-up examinations. It is important that radiologists interpreting pelvic MRI in case of suspected cervical cancer are familiar with the current FIGO staging system. This is the only way to determine the tumor stage as precisely as possible and thus lay the foundation for the success of therapy for patients. The aim of this review is to present the changes of the revised FIGO classification as well as to show the importance of MRI as the method of choice for local-regional tumor staging as a complement to clinical examination. Key Points: Citation Format

Artificial Intelligence in Cervical Cancer Screening and Diagnosis

“…MRI has proven to be highly accurate in the preoperative staging of cervical cancer ( 78 , 79 ). Therefore, MRI is the first choice for local staging, evaluation of treatment response, detection of tumor recurrence, and follow-up of patients with cervical cancer ( 80 ). The primary objective of MRI is to determine the presence of peritumoral infiltration and lymph node metastasis (LNM) ( 81 ) ( Table 7 ).…”

Preoperative planning of arterial chemoembolization with drug-saturated microspheres for women with recurrent pelvic tumors complicated by bleeding

“…Трансартериальная химиоэмболизация не так давно стала применяться в онкогинекологии. На сегодняшний день есть публикации, демонстрирующие эффективность этой методики при лечении первичных опухолей у женщин, и единичные наблюденияпри рецидивных опухолях [10][11][12][13][14][15][16][17][18][19][20]. Однако особенности предоперационного планирования ТАХЭ не освещаются и требуют изучения.…”

Useful MRI Findings for Minimally Invasive Surgery for Early Cervical Cancer

“…Magnetic resonance imaging (MRI) is more precise at estimating tumor volume than is physical examination because it offers good soft tissue contrast, which enables accurate measurement of three-dimensional axes [13][14][15][16][17][18]. Recent FIGO staging guidelines are based on lymph node metastasis in the abdomen and pelvis [19][20][21][22][23]. However, it is not possible to assess lymph node metastasis by physical examination alone [24,25].…”