Staging of uterine cervical cancer with MRI: guidelines of the European Society of Urogenital Radiology.
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 orientation (short and long axis of the uterine cervix) of the pelvic content. Axial T1-weighted sequence is useful to detect suspicious pelvic and abdominal lymph nodes, and images from symphysis to the left renal vein are required. The intravenous administration of Gadolinium-chelates is optional but is often required for small lesions (<2 cm) and for follow-up after treatment. Diffusion-weighted sequences are optional but are recommended to help evaluate lymph nodes and to detect a residual lesion after chemoradiotherapy.


CONCLUSIONS
Expert consensus and literature review lead to an optimized MRI protocol to stage uterine cervical cancer. MRI is the imaging modality of choice for preoperative staging and follow-up in patients with uterine cervical cancer.
Radiology Department, Institut Gustave Roussy, 39, rue Camille Desmoulins, 94805 Villejuif, Cedex, France. corinne.balleyguier@igr.fr
Corinne
C
Balleyguier
E
E
Sala
T
T
Da Cunha
A
A
Bergman
B
B
Brkljacic
F
F
Danza
R
R
Forstner
B
B
Hamm
R
R
Kubik-Huch
C
C
Lopez
R
R
Manfredi
J
J
McHugo
L
L
Oleaga
K
K
Togashi
K
K
Kinkel
D000328:Adult; D016477:Artifacts; D002614:Chelating Agents / Q000494:pharmacology; D003287:Contrast Media / Q000494:pharmacology; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D005682:Gadolinium / Q000494:pharmacology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008495:Medical Oncology / Q000379:methods*; D008875:Middle Aged; D009038:Motion; D009367:Neoplasm Staging; D011871:Radiology / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology*
D002614:Chelating Agents; D003287:Contrast Media; D005682:Gadolinium