Revised FIGO Staging for Cervical Cancer – A New Role for MRI

Abstract

Cervical cancer is still the fourth most common malignancy in women worldwide and has a high mortality rate. The prognosis as well as the therapy depends largely on the extent of the tumor at the time of initial diagnosis. This shows the importance of correct staging of cervical cancer. In order to promote a globally uniform approach, staging of cervical cancer in the past was based on widespread examinations such as exam under anesthesia, histology from cervical conization or biopsy, systematic lymphadenectomy, cystoscopy, proctoscopy, i. v.-pyelogram and chest X-ray. However, as the primary tumor stage was often underestimated, the 2018 revised FIGO classification now permits cross-sectional imaging techniques and pathological findings to be incorporated into disease staging or an already existing stage to be adapted based on radiological findings. Thanks to its excellent soft tissue contrast, magnetic resonance imaging (MRI) is the method of choice for local-regional staging of cervical cancer, evaluating the response to treatment, detecting tumor recurrence and for follow-up examinations. It is important that radiologists interpreting pelvic MRI in case of suspected cervical cancer are familiar with the current FIGO staging system. This is the only way to determine the tumor stage as precisely as possible and thus lay the foundation for the success of therapy for patients. The aim of this review is to present the changes of the revised FIGO classification as well as to show the importance of MRI as the method of choice for local-regional tumor staging as a complement to clinical examination. KEY POINTS:: · Cervical cancer is still the world's fourth most common female cancer and has a high mortality rate.. · The FIGO classification for staging cervical cancer in the past was based on clinical and widespread examinations.. · The primary tumor stage has often been underestimated with the FIGO staging system since 2018.. · Since 2018, cross-sectional imaging techniques have been incorporated into disease staging.. · MRI is the method of choice for local-regional tumor staging, evaluation of the response to treatment, detection of tumor recurrence and possible complications.. CITATION FORMAT: · Merz J, Bossart M, Bamberg F et al. Revised FIGO Staging for Cervical Cancer - A New Role for MRI. Fortschr Röntgenstr 2020; 192: 937 - 944.