Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065.
Department of Radiology, Cork University Hospital, Cork, Ireland.
AJR Am J Roentgenol. 2023 Nov;221(5):633-648. doi: 10.2214/AJR.23.29003. Epub 2023 Jun 7.
This review provides a practical approach to the imaging evaluation of patients with cervical cancer (CC), from initial diagnosis to restaging of recurrence, focusing on MRI and FDG PET. The primary updates to the International Federation of Gynecology and Obstetrics (FIGO) CC staging system, as well as these updates' relevance to clinical management, are discussed. The recent literature investigating the role of MRI and FDG PET in CC staging and image-guided brachytherapy is summarized. The utility of MRI and FDG PET in response assessment and posttreatment surveillance is described. Important findings on MRI and FDG PET that interpreting radiologists should recognize and report are illustrated. The essential elements of structured reports during various phases of CC management are outlined. Special considerations, including the role of imaging in patients desiring fertility-sparing management, differentiation of CC and endometrial cancer, and unusual CC histologies, are also described. Finally, future research directions including PET/MRI, novel PET tracers, and artificial intelligence applications are highlighted.
本文针对宫颈癌（CC）患者的影像学评估，从初始诊断到复发的再分期，重点介绍 MRI 和 FDG PET，提供了一种实用方法。讨论了国际妇产科联合会（FIGO）CC 分期系统的主要更新，以及这些更新对临床管理的相关性。总结了最近研究 MRI 和 FDG PET 在 CC 分期和图像引导近距离治疗中的作用的文献。描述了 MRI 和 FDG PET 在反应评估和治疗后监测中的应用。举例说明了解释放射科医生应识别和报告的 MRI 和 FDG PET 上的重要发现。概述了在 CC 管理的各个阶段进行结构化报告的基本要素。还描述了特殊考虑因素，包括影像学在希望保留生育能力的患者中的作用、CC 和子宫内膜癌的鉴别诊断，以及不常见的 CC 组织学。最后，强调了包括 PET/MRI、新型 PET 示踪剂和人工智能应用在内的未来研究方向。
