Pelvic cervical carcinoma protocol (MRI)
A dedicated pelvic MRI protocol is very useful for imaging assessment of cervical carcinoma.
Although the FIGO is a clinical staging, the 2009 revised FIGO staging encourages the use of MRI to complement clinical staging.
Imaging is optimally performed after three hours of fasting to reduce bowel peristalsis and following administration of an anti-peristaltic agent unless contra-indicated.
Half full urinary bladder to improve detection of bladder wall invasion.
Supine position using a pelvic phased array multicoil.
T2 weighted imaging in 3 orthogonal planes to the long axis of the cervix; a coronal view of the cervix best depicts parametrial invasion:
- high resolution matrix
- small field of view (FOV)
- slice thickness 2-4 mm
T1 weighted imaging to detect lympadenopathy
- large FOV
- axial imaging to renal hila
Contrast sequences are not routinely recommended for the staging of cervical carcinoma except for small tumours where uterine conserving trachlectomy is being considered. It may also be useful to image tumour recurrence.
- dynamic sagittal 3D T1 weighted sequence
- single pre contrast run with 4 post contrast acquisitions
- 1. Balleyguier C, Sala E, Da cunha T et-al. Staging of uterine cervical cancer with MRI: guidelines of the European Society of Urogenital Radiology. Eur Radiol. 2011;21 (5): 1102-10. doi:10.1007/s00330-010-1998-x - Pubmed citation
- 2. Pecorelli S. Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int J Gynaecol Obstet. 2009;105 (2): 103-4. - Pubmed citation