Staging, recurrence and follow-up of uterine cervical cancer using MRI: Updated Guidelines of the European Society of Urogenital Radiology after revised FIGO staging 2018

Lucia Manganaro¹, Yulia Lakhman², Nishat Bharwani^{3

4}, Benedetta Gui⁵, Silvia Gigli⁶, Valeria Vinci⁷, Stefania Rizzo⁸, Aki Kido⁹, Teresa Margarida Cunha¹⁰, Evis Sala¹¹, Andrea Rockall^{12

13}, Rosemarie Forstner¹⁴, Stephanie Nougaret^{15

16}

Affiliations

¹ Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Viale Regina Elena, 324 00161, Rome, Italy. lucia.manganaro@uniroma1.it.
² Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
³ Department of Surgery and Cancer, Imperial College, London, UK.
⁴ Department of Radiology, St Mary's Hospital, Imperial College Healthcare NHS Trust, Department of Surgery and Cancer, Imperial College, London, 3rd Floor, Queen Elizabeth the Queen Mother Building, Praed St., London, W21NY, UK.
⁵ Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Radiologia Generale ed Interventistica Generale, Area Diagnostica per Immagini, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy.
⁶ Department of Diagnostic Imaging, Sandro Pertini Hospital, Via dei Monti Tiburtini, 385, 00157, Rome, Italy.
⁷ Department of Radiology, Aerospace Medical Institute, Viale Piero Gobetti, Rome, Italy.
⁸ Department of Radiology, Università della Svizzera Italiana (USI), EOC via Tesserete 46, Lugano, 6900, Switzerland.
⁹ Department of Diagnostic Radiology and Nuclear Medicine, Kyoto University Hospital, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan.
¹⁰ Department of Radiology, Instituto Português de Oncologia de Lisboa Francisco Gentil, R. Prof. Lima Basto, 1099-023, Lisbon Codex, Portugal.
¹¹ Department of Radiology, Cambridge Biomedical Campus Cambridge, Box 218, Cambridge, CB2 0QQ, UK.
¹² Department of Surgery and Cancer, Faculty of Medicine, Imperial College, London, UK.
¹³ Department of Radiology, Imperial College Healthcare NHS Trust, London, UK.
¹⁴ Department of Radiology, PMU, Müllner Hauptstr, 48 Universitätsklinikum, 5020, Salzburg, Austria.
¹⁵ Department of Radiology, University of Montpellier, Montpellier, France.
¹⁶ INSERM, Montpellier Cancer Research Institute, U1194, University of Montpellier, 208 Avenue des Apothicaires, 34295, Montpellier, France.

PMID: 33852049
DOI: 10.1007/s00330-020-07632-9

Staging, recurrence and follow-up of uterine cervical cancer using MRI: Updated Guidelines of the European Society of Urogenital Radiology after revised FIGO staging 2018

Lucia Manganaro et al. Eur Radiol. 2021 Oct.

. 2021 Oct;31(10):7802-7816.

doi: 10.1007/s00330-020-07632-9. Epub 2021 Apr 14.

Authors

Affiliations

¹ Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Viale Regina Elena, 324 00161, Rome, Italy. lucia.manganaro@uniroma1.it.
² Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
³ Department of Surgery and Cancer, Imperial College, London, UK.
⁴ Department of Radiology, St Mary's Hospital, Imperial College Healthcare NHS Trust, Department of Surgery and Cancer, Imperial College, London, 3rd Floor, Queen Elizabeth the Queen Mother Building, Praed St., London, W21NY, UK.
⁵ Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Radiologia Generale ed Interventistica Generale, Area Diagnostica per Immagini, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy.
⁶ Department of Diagnostic Imaging, Sandro Pertini Hospital, Via dei Monti Tiburtini, 385, 00157, Rome, Italy.
⁷ Department of Radiology, Aerospace Medical Institute, Viale Piero Gobetti, Rome, Italy.
⁸ Department of Radiology, Università della Svizzera Italiana (USI), EOC via Tesserete 46, Lugano, 6900, Switzerland.
⁹ Department of Diagnostic Radiology and Nuclear Medicine, Kyoto University Hospital, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan.
¹⁰ Department of Radiology, Instituto Português de Oncologia de Lisboa Francisco Gentil, R. Prof. Lima Basto, 1099-023, Lisbon Codex, Portugal.
¹¹ Department of Radiology, Cambridge Biomedical Campus Cambridge, Box 218, Cambridge, CB2 0QQ, UK.
¹² Department of Surgery and Cancer, Faculty of Medicine, Imperial College, London, UK.
¹³ Department of Radiology, Imperial College Healthcare NHS Trust, London, UK.
¹⁴ Department of Radiology, PMU, Müllner Hauptstr, 48 Universitätsklinikum, 5020, Salzburg, Austria.
¹⁵ Department of Radiology, University of Montpellier, Montpellier, France.
¹⁶ INSERM, Montpellier Cancer Research Institute, U1194, University of Montpellier, 208 Avenue des Apothicaires, 34295, Montpellier, France.

PMID: 33852049
DOI: 10.1007/s00330-020-07632-9

Erratum in

Correction to: Staging, recurrence and follow-up of uterine cervical cancer using MRI: Updated Guidelines of the European Society of Urogenital Radiology after revised FIGO staging 2018.
Manganaro L, Lakhman Y, Bharwani N, Gui B, Gigli S, Vinci V, Rizzo S, Kido A, Cunha TM, Sala E, Rockall A, Forstner R, Nougaret S. Manganaro L, et al. Eur Radiol. 2022 Jan;32(1):738. doi: 10.1007/s00330-021-08066-7. Eur Radiol. 2022. PMID: 34142221 No abstract available.

Abstract

Objectives: The recommendations cover indications for MRI examination including acquisition planes, patient preparation, imaging protocol including multi-parametric approaches such as diffusion-weighted imaging (DWI-MR), dynamic contrast-enhanced imaging (DCE-MR) and standardised reporting. The document also underscores the value of whole-body 18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG-PET/CT) and highlights potential future methods.

Methods: In 2019, the ESUR female pelvic imaging working group reviewed the revised 2018 FIGO staging system, the up-to-date clinical management guidelines, and the recent imaging literature. The RAND-UCLA Appropriateness Method (RAM) was followed to develop the current ESUR consensus guidelines following methodological steps: literature research, questionnaire developments, panel selection, survey, data extraction and analysis.

Results: The updated ESUR guidelines are recommendations based on ≥ 80% consensus among experts. If ≥ 80% agreement was not reached, the action was indicated as optional.

Conclusions: The present ESUR guidelines focus on the main role of MRI in the initial staging, response monitoring and evaluation of disease recurrence. Whole-body FDG-PET plays an important role in the detection of lymph nodes (LNs) and distant metastases.

Key points: • T2WI and DWI-MR are now recommended for initial staging, monitoring of response and evaluation of recurrence. • DCE-MR is optional; its primary role remains in the research setting. • T2WI, DWI-MRI and whole-body FDG-PET/CT enable comprehensive assessment of treatment response and recurrence.

Keywords: Diffusion Weighted Imaging; Magnetic Resonance Imaging; Neoplasm recurrence; Neoplasm staging; Uterine cervical neoplasms.

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References

1. Balleyguier C, Sala E, Da Cunha T et al (2011) Staging of uterine cervical cancer with MRI: guidelines of the European Society of Urogenital Radiology. Eur Radiol 21(5):1102–1110 - PubMed - DOI - PMC
1. Qin Y, Peng Z, Lou J, Liu H, Deng F, Zheng Y (2009) Discrepancies between clinical staging and pathological findings of operable cervical carcinoma with stage IB-IIB: a retrospective analysis of 818 patients. Aust N Z J Obstet Gynaecol 49(5):542–544
1. Bhatla N, Aoki D, Sharma DN, Sankaranarayanan R (2018) Cancer of the cervix uteri. Int J Gynecol Obstet 143(Suppl 2):22–36
1. Young P, Daniel B, Sommer G, Kim B, Herfkens R (2012) Intravaginal gel for staging of female pelvic cancers--preliminary report of safety, distention, and gel-mucosal contrast during magnetic resonance examination. J Comput Assist Tomogr 36(2):253
1. Van Hoe L, Vanbeckevoort D, Oyen R, Itzlinger U, Vergote I (1999) Cervical carcinoma: optimized local staging with intravaginal contrast-enhanced MR imaging--preliminary results. Radiology 213(2):608–611 - PubMed - DOI - PMC

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Staging, recurrence and follow-up of uterine cervical cancer using MRI: Updated Guidelines of the European Society of Urogenital Radiology after revised FIGO staging 2018

Affiliations

Staging, recurrence and follow-up of uterine cervical cancer using MRI: Updated Guidelines of the European Society of Urogenital Radiology after revised FIGO staging 2018

Authors

Affiliations

Erratum in

Abstract

References

MeSH terms

Substances

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical