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.
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Preparation
Imaging is optimally performed after three hours of fasting to reduce bowel peristalsis and following administration of an anti-peristaltic agent unless contraindicated.
Half-full urinary bladder to improve detection of bladder wall invasion.
Supine position using a pelvic phased-array multi-coil.
Sequences
Pre-contrast imaging
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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
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T1 weighted imaging to detect lymphadenopathy
- large FOV
- axial imaging to renal hila
Post-contrast imaging
Contrast sequences are not routinely recommended for the staging of cervical carcinoma except for small tumors where uterine conserving trachelectomy is being considered. It may also be useful to image tumor recurrence.
- dynamic sagittal 3D T1 weighted sequence
- single pre-contrast run with four post-contrast acquisitions
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