Cervical cancer is the fourth most common cancer in women worldwide and the most common gynaecological malignancy. The FIGO staging system is the most commonly utilised classification system for cervical cancer worldwide. Prior to the most recent update in the FIGO staging in 2018, the staging was dependent upon clinical assessment alone. Concordance between the surgical and clinical FIGO staging decreases rapidly as the tumour becomes more advanced. MRI now plays a central role in patients diagnosed with cervical cancer and enables accurate staging, which is essential to determining the most appropriate treatment. MRI is the best imaging option for the assessment of tumour size, location, and parametrial and sidewall invasion. Notably, the presence of parametrial invasion precludes surgical options, and the patient will be triaged to chemoradiotherapy. As imaging is intrinsic to the new 2018 FIGO staging system, nodal metastases have been included within the classification as stage IIIC disease. The presence of lymph node metastases within the pelvis or abdomen is associated with a poorer prognosis, which previously could not be included in the staging classification as these could not be reliably detected on clinical examination. MRI findings corresponding to the 2018 revised FIGO staging of cervical cancers and their impact on treatment selection will be described.
宫颈癌是全球女性第四大常见癌症，也是最常见的妇科恶性肿瘤。国际妇产科联盟（FIGO）分期系统是全球范围内最广泛应用的宫颈癌分类体系。在2018年FIGO分期系统最新修订前，分期仅依赖于临床评估。随着肿瘤进展，手术分期与临床FIGO分期的一致性显著降低。目前磁共振成像（MRI）在宫颈癌诊疗中发挥核心作用，能够实现精准分期，这对制定最佳治疗方案至关重要。MRI是评估肿瘤大小、位置、宫旁浸润及盆壁侵犯的最佳影像学手段。值得注意的是，若存在宫旁浸润则排除手术治疗可能，患者将接受放化疗。由于影像学已成为2018新版FIGO分期系统的内在组成部分，淋巴结转移现被纳入IIIC期分类。盆腔或腹部淋巴结转移的存在提示预后不良，而此前因临床检查无法可靠检测此类转移，故未能纳入分期体系。本文将阐述与2018修订版FIGO宫颈癌分期相对应的MRI表现及其对治疗方案选择的影响。
An Update on the Role of MRI in Treatment Stratification of Patients with Cervical Cancer
肿瘤(癌症)患者之家