MRI and PET/CT Can Help Prevent Unnecessary Treatment of Some Cervical Cancer Patients

Magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT) can help spare patients with clinically operable cervical cancer from unnecessary high-morbidity treatment; however, pretreatment imaging does not lead to increased survival of these patients.

"We developed a decision-analytic model to determine the value of pretreatment imaging in the patients with stage 1B cervical cancer,” said Pari Pandharipande, M.D., M.P.H., from Massachusetts General Hospital (Boston, MA, USA) and lead author of the study. "What we found was that PET/CT alone best triages patients to the correct primary therapy,” she said.

The percentage of patients triaged to optimal first line therapy was 89% with PET/CT, according to Dr. Pandharipande. That compared to 82% with no imaging, 75% with MRI and PET/CT, and 68% with MRI. These patients are treated with either surgery, chemoradiation, or surgery followed by chemoradiation (trimodality therapy).

"When MRI and PET/CT are combined, it best prevents undesired triage to high-morbidity trimodality therapy,” said Dr. Pandharipande. The study found that the percentage of patients spared trimodality therapy were 95% when both MRI and PET/CT were used, 92% with PET/CT alone, 91.6% with MRI alone, and 82% with no imaging, she said.

Whereas imaging helps define the extent of disease and thus helps determine appropriate treatment, the study found that five-year survival estimates were similar (approximately 92%) regardless of whether the patient had no pretreatment imaging, or pretreatment imaging with PET/CT alone, MRI alone or both PET/CT and MRI.

"MRI and PET/CT are commonly used to guide management decisions for patients with early cervical cancer,” said Dr. Pandharipande. "This study provides us with an evidence-based approach to the role of preoperative imaging for these patients.”


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