MRI (Including Spectroscopy and Fat-Saturations and Diffusion-Weighted Imaging) in Cervical Cancer

At our institution, all patients receiving external beam and/or brachytherapy as part of the treatment of primary cervical cancer receive CT, PET, and MRI simulation scans as standard of care. Brachytherapy patients also receive weekly T1/T2 weighted MR simulation scans as part of their treatment planning.

We propose the use of additional MR sequences to the standard T1/T2 weighted MR simulation scans. The data obtained from these additional sequences will be used for improving tumor delineation and obtaining prognostic information.

Inclusion criteria

• Patients must have biopsy-proven newly diagnosed squamous cell cervical cancer (FIGO clinical stages IB2-IVA).
• Patients must be ≥ 18 years of age.
• Patients must be able to receive standard radiation therapy (external beam radiation and brachytherapy) with or without chemotherapy.
• Patients with distant metastatic disease are eligible provided the estimated survival of the patient is at least one year.
• Patients must be scheduled to undergo or have already undergone FDG-PET/CT imaging for clinical staging cervical cancer at Barnes-Jewish Hospital Clinical PET facility on the Siemens Biograph 40 True Point Tomograph Scanner or elsewhere in the WUSM Nuclear Medicine department using the quality controls instituted by Nuclear Medicine.
• Patients must be able to give informed consent.

Exclusion criteria

• Patients with another known active malignancy.
• Patients who have received treatment for any malignancy (with the exception of non-melanoma skin cancer) in the past 5 years.
• Pregnant or breastfeeding patients.
• Patients whose tumors are not FDG avid on baseline standard of care FDG-PET/CT imaging.
• Patients with contraindications to MRI scanning.