Uterine cervical cancer is the third most common gynaecological malignancy after endometrial and ovarian cancers.
Standard treatment for patients with locally advanced cervical cancer is chemoradiotherapy.
MRI is the imaging modality of choice for preoperative staging and follow-up in patients with cervical cancer.
The purpose of this study was to investigate diagnostic capabilities of MRI for evaluation of effectiveness of neoadjuvant chemotherapy (NACT) with uterine arteries chemoembolization (UACE) and for preoperative staging of cervical cancer.
Methods and Materials
40 consecutive patients aged 25-63 y.
with clinical stage IIB-IIIB uterine cervical cancer were included in this study approved by institutional board.
Informed consent was obtained in all cases.
Treatment consisted of one courses of systemic chemotherapy and one course of bilateral UACE with gemcitabine plus lipiodol followed by hysterectomy with pelvic lymphadenectomy.
Pelvic MRI was performed before start of treatment and repeated before surgery.
Maximal tumor diameter was measured and tumor response evaluated using RECIST criteria .
Criterion for partial response was decrease...
Oil emboli deposition in the tumor after UACE was clearly seen on CT images as zones of high density (about 150 Hounsfield units) while MRI was not able to demonstrate this (Fig.
Based on preoperative MRI data complete tumor response after NACT was observed in 7 of 40 (18%) patients.
In those patients increased signal intensity zone corresponding to tumor was not visualized on T2W images any more with complete or partial recovery of hypointense cervical stroma (Fig.
Deficit of cervical tissues occurred...
In patients with uterine cervix cancer treated with neoadjuvant chemotherapy with uterine arteries chemoembolization the overall tumor response rate (complete response + partial response) was 70% (28/40).
In 5 of 7 complete MRI responses isolated cancer cells were revealed on pathology.
Residual stage IA tumor was not detected by MRI in another 1 patient.
specificity and accuracy of MRI in the detection of stage IA or greater residual tumor were 97%,
100% and 98% respectively.
specificity and accuracy of MRI in the detection...
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Department of Diagnostic Radiology
Alexandrov National Cancer Center of Belarus
223040 Minsk Region,