Functional MRI boosts early staging of cervical cancer

February 17, 2009 Diagnostic Imaging. By H.A. Abella Diffusion-weighted MRI added to standard T2-weighted scans can help spot cervical cancer in its early stages. A preliminary study from the Institute of Cancer Research in London determined that DWI can spot tumors missed by T2 imaging and bolster management options for women who wish to preserve reproductive organs. During the past half-century, the rate of deaths linked to cervical cancer has been cut in half in many countries that have adopted the Pap smear and other cervical screening tests. Preventive measures including vaccination are credited with helping to bring down the death rate by nearly 4% annually. According to the American Cancer Society, however, about 4000 women died of cervical cancer in the U.S. last year. Early staging determines prognosis and management, which in most cases means hysterectomy or other surgical alternatives. Several studies have shown that T2-weighted MRI can refine the standard International Federation of Gynecology and Obstetrics (FIGO) staging, particularly for the preoperative assessment. Patients often show up for MR, however, after undergoing biopsy, which hinders T2-imaging interpretation and the ability to detect residual disease. This, in turn, limits management options such as uterine conservation when it is not only desirable but possible. Adding DWI could improve the detection of small but clinically important lesions that are difficult to image and often missed, said senior investigator Dr. Nandita M. deSouza, a fellow of the Royal College of Radiology and codirector of the Institute of Cancer Research's Clinical MR Research Group.

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