Magnetic Resonance Imaging of the Cervix, and its Relevance to the Revised International Federation of Gynecology and Obstetrics (FIGO) Staging

Abstract

The International Federation of Gynecology and Obstetrics (FIGO) staging system is the oldest and most widely used system for treatment planning and prognosis in cervical cancer. On the 1st of June 2009 the FIGO committee introduced the revised staging of cervical carcinoma updating the previous staging of 1988. Although FIGO staging system does not include radiology in the staging of cervical cancer, the committee encourages the use of imaging techniques if available to assess the important prognostic factors such as parametrial and pelvic side wall invasion, tumor size and the evaluation of lymph node metastases. Imaging is therefore complimentary to the clinical assessment with magnetic resonance (MR) imaging accepted as the optimal modality to stage cervical carcinoma. This article will discuss and illustrate the new FIGO staging, the impact of imaging on treatment and optimal image acquisition with respect to MR imaging. Radiologists must familiarise themselves with the new staging and understand its relevance to patient management Keywords: MRI, Cervical cancer, FIGO, staging, prognostic factors, recurrence, lymph nodes