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Original Research

Open Access

Is magnetic resonance imaging useful in early evaluation of women on neoadjuvant chemotherapy for locally advanced cervical cancer?

  • P. SALA1,*,
  • P. Marchiolè2
  • G. Cittadini3
  • M. Valenzano Menada1
  • M. Moioli1
  • S. Mammoliti4
  • S. Costantini1

1Operative Unit of Clinical Obstetrics and Gynecology, San Martino Hospital, University of Genoa, Genoa, Italy

2Department of Gynecology and Obstetrics, Villa Scassi Hospital-ASL3, Genoa, Italy

3Department of Radiology, San Martino Hospital, University of Genoa, Genoa, Italy

4Department of Medical Oncology, San Martino Hospital, Genoa, Italy

DOI: 10.12892/ejgo20120131 Vol.33,Issue 1,January 2012 pp.31-36

Published: 10 January 2012

*Corresponding Author(s): P. SALA E-mail:


Objective: To evaluate the accuracy of magnetic resonance imaging (MRI) in staging cervical tumors after neoadjuvant chemotherapy (NACT). Methods: 26 women, affected by locally advanced cervical cancer and triaged for surgery after NACT, were submitted to three cycles of neoadjuvant chemotherapy. All patients were submitted to MRI before and after NACT. We evaluated the MRI sensitivity and specificity in staging cervical tumors after chemotherapy, relating MRI findings after NACT with the pathological findings as the gold standard. Results: In our series, MRI sensitivity was 58.8% and specificity was 66.7%. Conclusions: In our study MRI accuracy after NACT was lower than that of MRI used to stage patients with early cervical cancer scheduled for primary surgery, reported by the literature. MRI false negative cases are the major problem because of the delay in application of an effective therapy in non responders to NACT.


Locally advanced cervical cancer (LACC); Neoadjuvant chemotherapy (NACT); Magnetic resonance imaging (MRI); Early response evaluation

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P. SALA,P. Marchiolè,G. Cittadini,M. Valenzano Menada,M. Moioli,S. Mammoliti,S. Costantini. Is magnetic resonance imaging useful in early evaluation of women on neoadjuvant chemotherapy for locally advanced cervical cancer?. European Journal of Gynaecological Oncology. 2012. 33(1);31-36.


[1] Jemal A., Siegel R., Ward E., Murray T., Xu J., Smigal C. et al.: “Cancer Statistics, 2006”. CA Cancer J. Clin., 2006, 56, 106.

[2] Ozsarlak O., Tjalma W., Schepens E., Corthouts B., Op de Beeck B., Van Marck E. et al.: “The correlation of preoperative CT, MR imaging and clinical staging (FIGO) with histopathology findings in primary cervical carcinoma”. Eur. Radiol., 2003, 13, 2338.

[3] De Vincenzo R., Amadio G., Ricci C., Licameli A., Ferrandina G., Capelli G. et al.: “Treatment of cervical cancer in Italy: strategies and their impact on the women”. Vaccine, 2009, 27 (suppl. 1), A39.

[4] Mabuchi S., Ugaki H., Isohashi F., Yoshioka Y., Temma K., Yada-Hashimoto N. et al.: “Concurrent weekly nedaplatin, external beam radiotherapy and high-doserate brachytherapy in patients with FIGO Stage IIIb cervical cancer: a comparison with a cohort treated by radiotherapy alone”. Gynecol. Obstet. Invest., 2010, 69, 224.

[5] Benedetti Panici P., Bellati F., Pastore M., Manci N., Musella A., Pauselli S. et al.: “An update in neoadjuvant chemotherapy in cer-vical cancer”. Gynecol. Oncol., 2007, 107 (1 suppl. 1), S20.

[6] Loizzi V., Cormio G., Vicino M., Selvaggi L.: “Neoadjuvant chemotherapy: an alternative option of treatment for locally advanced cervical cancer”. Gynecol. Obstet. Invest., 2008, 65, 96.

[7] Manfredi R., Maresca G., Smaniotto D., Greggi S., Andrulli D., Rabitti C. et al.: “Cervical cancer response to neoadjuvant therapy: MR imaging assessment”. Radiology, 1998, 209, 819.

[8] Jeong Y.Y., Kang H.K., Chung T.W., Seo J.J., Park J.G.: “Uterine cervical carcinoma after therapy: CT and MR imaging findings”. Radiographics, 2003, 23, 969.

[9] Marchiolè P., Cittadini G., Sala P., Moioli M., Mathevet P., Capaccio E. et al.: “Pre- and post-operative work-up in patients affected by early invasive cervical cancer and eligible for fertility sparing treatment: role of MRI with saline hydrocolpos”. Abdom Imaging, 2010, 35, 271.

[10] World Health Organization (WHO). WHO Handbook for reporting results for cancer treatment criteria. Geneva 1979.

[11] Sardi J., Sananes C., Giaroli A., Maya G., di Paola G.: “Neoadjuvant chemotherapy in locally advanced carcinoma of cervix uteri”. Gynecol. Oncol., 1990, 38, 486.

[12] Benedetti-Panici P., Greggi S., Colombo A., Amoroso M., Smaniotto D., Giannarelli D. et al.: “Neoadjuvant chemotherapy and radical surgery versus exclusively radiotherapy in locally advanced squamous cell cervical cancer: results from the Italian multi-centre randomized study”. J. Clin. Oncol., 2002, 1, 20, 179.

[13] Benedetti Panici P., Greggi S., Scambia G., Amoroso M., Salerno M.G., Maneschi F. et al.: “Long-term survival following neoadjuvant chemotherapy and radical surgery in locally advanced cervical cancer”. Eur. J. Cancer, 1998, 34, 341.

[14] Neoadjuvant chemotherapy for locally advanced cervical cancer Meta-analysis Collaboration. Neoadjuvant chemotherapy for locally advanced cervical cancer: a systematic review and metaanalysis of individual patient data from 21 randomized trials. Eur. J. Cancer, 2003, 39, 2470.

[15] Testa A.C., Ludovisi M., Manfredi R., Zannoni G., Gui B., Basso D. et al.: “Transvaginal ultrasonography and magnetic resonance imaging for assessment of presence, size and extent of invasive cervical cancer”. Ultrasound Obstet. Gynecol., 2009, 34, 335.

[16] Harry V.N.: “Novel imaging techniques as response biomarkers in cervical cancer”. Gynecol. Oncol., 2010, 116, 253.

[17] Payne G.S., Schmidt M., Morgan V.A., Giles S., Bridges J., Ind T. et al.: “Evaluation of magnetic resonance diffusion and spectroscopy measurements as predictive biomarkers in Stage I cervical cancer”. Gynecol. Oncol., 2010, 116, 246.

[18] Yuh W.T., Mayr N.A., Jarjoura D., Wu D., Grecula J.C., Lo S.S. et al.: “Predicting control of primary tumor and survival by DCE MRI during early therapy in cervical cancer”. Invest. Radiol., 2009, 44, 343.

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