Role of magnetic resonance imaging as an adjunct to clinical staging in cervical carcinoma

Magnetic resonance imaging depicts the morphological details of the female pelvis and is useful for evaluating both benign and malignant cervical masses. Clinical assessment of the extent of cervical cancer is crucial in determining the optimal treatment strategy, but clinical staging by itself has limitations. Clinical staging, as defined by FIGO (International Federation of Gynecologic Oncology), is based on the findings of physical examination, lesion biopsies, chest radiography, cystoscopy, and renal sonography and can be erroneous, depending on the stage of the disease, by 16% to 65%. The prognosis of cervical cancer is determined not only by stage, but also by nodal status, tumor volume, and depth of invasion, none of which are included in the FIGO guidelines. Magnetic resonance imaging has been described as the most accurate, noninvasive imaging modality in staging cervical carcinoma. This review outlines the magnetic resonance features of normal cervix, primary disease (by stage), and recurrent disease and discusses the role of magnetic resonance imaging in staging and clinical decision making.