Integrated PET/MRI for whole-body staging of patients with primary cervical cancer: preliminary results

  • Johannes GrueneisenEmail author
  • Benedikt Michael Schaarschmidt
  • Martin Heubner
  • Bahriye Aktas
  • Sonja Kinner
  • Michael Forsting
  • Thomas Lauenstein
  • Verena Ruhlmann
  • Lale Umutlu
Original Article



To assess the diagnostic value of integrated PET/MRI for whole-body staging of cervical cancer patients, as well as to investigate a potential association between PET/MRI derived functional parameters and prognostic factors of cervical cancer.


The present study was approved by the local institutional review board. Twenty-seven patients with histopathologically confirmed cervical cancer were prospectively enrolled in our study. All patients underwent a whole-body PET/MRI examination after written informed consent was obtained. Two radiologists separately evaluated the PET/MRI data sets regarding the determination of local tumor extent of primary cervical cancer lesions, as well as detection of nodal and distant metastases. Furthermore, SUV and ADC values of primary tumor lesions were analyzed and correlated with dedicated prognostic factors of cervical cancer. Results based on histopathology and cross-sectional imaging follow-up served as the reference standard.


PET/MRI enabled the detection of all 27 primary tumor lesions of the uterine cervix and allowed for the correct determination of the T-stage in 23 (85 %) out of the 27 patients. Furthermore, the calculated sensitivity, specificity and diagnostic accuracy for the detection of nodal positive patients (n = 11) were 91 %, 94 % and 93 %, respectively. PET/MRI correctly identified regional metastatic disease (N1-stage) in 8/10 (80 %) patients and non-regional lymph node metastases in 5/5 (100 %) patients. In addition, quantitative analysis of PET and MRI derived functional parameters (SUV; ADC values) revealed a significant correlation with pathological grade and tumor size (p < 0.05).


The present study demonstrates the high potential of integrated PET/MRI for the assessment of primary tumor and the detection of lymph node metastases in patients with cervical cancer. Providing additional prognostic information, PET/MRI may serve as a valuable diagnostic tool for cervical cancer patients in a pretreatment setting.


PET/MRI Cervical cancer Primary tumor staging Standardized uptake value Apparent diffusion coefficient 



Lale Umutlu is a consultant for Bayer HealthCare.

Compliance with ethical standards

Conflicts of interest

The authors declare that they have no competing interests.

Research involving human participants and/or animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Research Committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Johannes Grueneisen
    • 1
    Email author
  • Benedikt Michael Schaarschmidt
    • 2
  • Martin Heubner
    • 3
  • Bahriye Aktas
    • 3
  • Sonja Kinner
    • 1
  • Michael Forsting
    • 1
  • Thomas Lauenstein
    • 1
  • Verena Ruhlmann
    • 4
  • Lale Umutlu
    • 1
  1. 1.Department of Diagnostic and Interventional Radiology and NeuroradiologyUniversity Hospital Essen, University of Duisburg-EssenEssenGermany
  2. 2.Department of Diagnostic and Interventional RadiologyUniversity Hospital Dusseldorf, University of DusseldorfDusseldorfGermany
  3. 3.Department of Obstetrics and GynecologyUniversity Hospital Essen, University of Duisburg-EssenEssenGermany
  4. 4.Department of Nuclear MedicineUniversity Hospital Essen, University of Duisburg-EssenEssenGermany

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