To outline the normal sequences used in a post chemoradiotherapy MRI of the cervix. To provide a pictorial description of expected post therapy changes and mimics of residual disease with histological correlation. To evaluate the sensitivity and specificity of MRI in this role.
Cervical cancer is the fourth most diagnosed cancer and the fourth leading cause of cancer death in women.
Combined chemoradiotherapy is the treatment of choice for patients with stage IIB,
or IVA cancer (1,
Patients usually undergo MRI at diagnosis/pre-treatment,
following chemotherapy and external beam radiotherapy and again post completion of brachytherapy,
if performed. MRI of the cervix is the investigation of choice for assessing the end response to radical chemoradiotherapy....
Findings and procedure details
A patient’s response to primary chemoradiotherapy for cervical cancer is assessed by comparing a post-treatment MRI cervix to the pre-treatment MRI.
depicts the standard protocol used in our institution for post chemoradiotherapy MRI of the cervix.
All imaging is performed on a Philips 1.5 T Achieva system.
All patients receive 20mg of Buscopan unless contraindicated.
IV contrast is not routinely administered unless the patient has had a prior hysterectomy.
The inability of MRI to reliably distinguish residual disease from post treatment inflammation requires the introduction of a universally accepted surveillance protocol which would include a definitive pathway for patients with an equivocal MRI.
Dr Roisin Heaney,Radiology Resident Department of Radiology,
St James Hospital,
Ireland. Email: firstname.lastname@example.org
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