Imaging in Cervical Cancer

Michele Follen, Charles F. Levenback, Revathy B. Iyer, Perry W. Grigsby, Erik A. Boss, Ebrahim S. Delpassand, Bruno D. Fornage, Elliot K Fishman

Research output: Contribution to journalArticle

Abstract

Cervical cancer traditionally has been staged clinically. Advances in imaging could improve the staging of cervical cancer by facilitating the detection of lymph node metastases and micrometastases in distant organs. Such progress could lead to improvements in treatment selection and therefore increase overall survival rates. At the Second International Conference on Clinical Cancer (Houston, TX, April 11-14, 2002), a panel composed of gynecologic oncologists, radiation oncologists, and diagnostic radiologists reviewed relevant technologies. Advances in lymphangiography, ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), and lymphatic mapping were reviewed, along with the impact of these advances on the diagnosis, treatment, and survival of patients with cervical cancer. Few cancer centers still use lymphangiography, but the sensitivity of this method ranges from 28% to 83%, with specificity ranging from 47% to 100%. The roles of transabdominal and transvaginal ultrasonography in evaluating cervical cancer are expected to expand when new contrast agents increase the sensitivity of these techniques to parametrial invasion and lymph node metastases; meanwhile, ultrasonography's most significant contributions may involve the identification of uterine and cervical leiomyomas and the evaluation of urinary tract obstruction. Advances in CT have made it a rival technique to MRI, but limitations prevent CT from providing definitive information on certain parameters. MRI, which is valuable because of its superior soft tissue contrast resolution, multiplanar capabilities, and cost-effectiveness, is used to determine the size of the cervix and to detect certain types of invasion, characteristics of lymph nodes, and the presence of disease in the ureter, lung, and liver. PET with 2-[fluorine-18]fluoro-2-deoxy-D-glucose has been found to detect abnormal lymph node regions better than CT does but PET can also be used in conjunction with CT to measure tumor dimensions. PET also has become a method for identifying tumors that are unresponsive to chemoradiation. When used together with immunohistochemical and molecular techniques as well as conventional stains, sentinel lymph node mapping, an important development in the surgical management of solid tumors, is expected to improve gynecologic cancer management. Advances in imaging methods and in contrast agents, along with advances in the combined use of the two, are expected to make imaging technologies more valuable in cervical cancer assessment.

Original languageEnglish (US)
Pages (from-to)2028-2038
Number of pages11
JournalCancer
Volume98
Issue number9 SUPPL.
StatePublished - Nov 1 2003

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Uterine Cervical Neoplasms
Lymph Nodes
Tomography
Positron-Emission Tomography
Lymphography
Ultrasonography
Neoplasms
Magnetic Resonance Imaging
Contrast Media
Neoplasm Metastasis
Technology
Neoplasm Micrometastasis
Fluorine
Deoxyglucose
Leiomyoma
Ureter
Urinary Tract
Cervix Uteri
Cost-Benefit Analysis
Coloring Agents

Keywords

  • Cervical cancer
  • Computed axial tomography
  • Imaging
  • Lymphography
  • Magnetic resonance imaging
  • Positron emission tomography
  • Staging
  • Ultrasonography

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Follen, M., Levenback, C. F., Iyer, R. B., Grigsby, P. W., Boss, E. A., Delpassand, E. S., ... Fishman, E. K. (2003). Imaging in Cervical Cancer. Cancer, 98(9 SUPPL.), 2028-2038.

Imaging in Cervical Cancer. / Follen, Michele; Levenback, Charles F.; Iyer, Revathy B.; Grigsby, Perry W.; Boss, Erik A.; Delpassand, Ebrahim S.; Fornage, Bruno D.; Fishman, Elliot K.

In: Cancer, Vol. 98, No. 9 SUPPL., 01.11.2003, p. 2028-2038.

Research output: Contribution to journalArticle

Follen, M, Levenback, CF, Iyer, RB, Grigsby, PW, Boss, EA, Delpassand, ES, Fornage, BD & Fishman, EK 2003, 'Imaging in Cervical Cancer', Cancer, vol. 98, no. 9 SUPPL., pp. 2028-2038.
Follen M, Levenback CF, Iyer RB, Grigsby PW, Boss EA, Delpassand ES et al. Imaging in Cervical Cancer. Cancer. 2003 Nov 1;98(9 SUPPL.):2028-2038.
Follen, Michele ; Levenback, Charles F. ; Iyer, Revathy B. ; Grigsby, Perry W. ; Boss, Erik A. ; Delpassand, Ebrahim S. ; Fornage, Bruno D. ; Fishman, Elliot K. / Imaging in Cervical Cancer. In: Cancer. 2003 ; Vol. 98, No. 9 SUPPL. pp. 2028-2038.
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