Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Br J Radiol. 2021 Sep 1;94(1125):20201342. doi: 10.1259/bjr.20201342. Epub 2021 May 14.
International Federation of Gynecology and Obstetrics (FIGO) staging, which is the fundamentally important cancer staging system for cervical cancer, has changed in 2018. New FIGO staging includes considerable progress in the incorporation of imaging findings for tumour size measurement and evaluating lymph node (LN) metastasis in addition to tumour extent evaluation. MRI with high spatial resolution is expected for tumour size measurements and the high accuracy of positron emmision tomography/CT for LN evaluation. The purpose of this review is firstly review the diagnostic ability of each imaging modality with the clinical background of those two factors newly added and the current state for LN evaluation. Secondly, we overview the fundamental imaging findings with characteristics of modalities and sequences in MRI for accurate diagnosis depending on the focus to be evaluated and for early detection of recurrent tumour. In addition, the role of images in treatment response and prognosis prediction is given with the development of recent technique of image analysis including radiomics and deep learning.
国际妇产科联合会(FIGO)分期是宫颈癌最重要的癌症分期系统,已于 2018 年更新。新的 FIGO 分期在肿瘤大小测量和评估淋巴结(LN)转移方面纳入了影像学发现,除了肿瘤范围评估外,还取得了相当大的进展。具有高空间分辨率的 MRI 有望用于肿瘤大小测量,正电子发射断层扫描/CT 具有较高的 LN 评估准确性。本综述的目的首先是在这两个新加入的因素的临床背景下,结合当前 LN 评估的情况,回顾每种影像学检查方法的诊断能力。其次,我们概述了 MRI 中根据评估焦点和早期检测复发性肿瘤的特点的各种成像模式和序列的基本影像学发现,以进行准确诊断。此外,随着包括放射组学和深度学习在内的图像分析新技术的发展,还介绍了图像在治疗反应和预后预测中的作用。