Back to the list
Congress: ECR25
Poster Number: C-18064
Type: Poster: EPOS Radiologist (educational)
DOI: 10.26044/ecr2025/C-18064
Authorblock: R. I. Rusu, A. M. Popescu, M. Calinescu; Bucharest/RO
Disclosures:
Raluca Ioana Rusu: Nothing to disclose
Adelina Maria Popescu: Nothing to disclose
Miruna Calinescu: Nothing to disclose
Keywords: Genital / Reproductive system female, Oncology, Pelvis, MR, Radiation therapy / Oncology, Cancer
Learning objectives Our learning objectives are: to review the restaging criteria after radiochemotherapy treatment and to assess the response to focus on imagistic differences between post-radiation changes and local recurrence to highlight the importance of DW-MRI in follow-up protocol
Read more Background Cervical cancer remains a significant global health issue, being the fourth leading cause of death in women, despite the introduction of screening programs. Around 30% of patients present with advanced disease at diagnosis, and 30-50% of those treated experience relapse within five years. For locally advanced cervical cancer (LACC), accurate staging and treatment planning are crucial. The 2018 FIGO staging system classifies stages IB3-IVA as LACC, where treatment options range from neoadjuvant chemoradiotherapy, external beam radiotherapy, brachytherapy, hysterectomy, or a...
Read more Findings and procedure details Imaging algorithm and follow-up In patients with LACC a pre-treatment MRI is performed for loco-regional staging. Choosing proper sequences and correct plane angles is extremely important to avoid pitfalls in follow-up evaluation post-CRT. (Ciulla et al., 2022)All subjects underwent 3Tesla MRIs, with T2-weighted imaging (oriented on cervical axial and coronal planes), diffusion-weighted imaging (DWI) (oriented on cervical axial plane) and dynamic contrast enhancement (DCE). The used protocol provides high anatomic resolution and is acquired on the cervical axis to provide better...
Read more Conclusion MRI is an essential tool for differentiating post-radiation fibrosis, inflammatory changes, and recurrent cervical cancer. While fibrosis appears hypointense on T2-weighted imaging with minimal enhancement, recurrent tumors demonstrate high T2 signal intensity, restricted diffusion, and early contrast enhancement.
Read more References Ciulla, S. et al. (2022). "Post treatment imaging in patients with local advanced cervical carcinoma. " In Frontiers in Oncology (Vol. 12). Hricak, H., et al. (2019). "Imaging after Radiotherapy for Cervical Cancer: Pitfalls and Challenges." Radiology, 291(2), 304-317. Huang, J., et al. (2022). "MRI Features of Recurrent Cervical Cancer: Differentiation from Post-Treatment Changes." AJR American Journal of Roentgenology, 218(5), 1124-1135. Kim, Y., et al. (2022). "MR Spectroscopy in Oncology: Applications and Future Directions." Cancer Imaging, 22(1), 47-56. Lakhman, Y., et al. (2021). "Diffusion-Weighted...
Read more
GALLERY