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Zervixkarzinom

Präoperatives Staging mittels Magnetresonanztomographie

Uterine cervical cancer

Preoperative staging with magnetic resonance imaging

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Zusammenfassung

Die Therapieplanung beim Zervixkarzinom ist weitgehend von der Stadieneinteilung nach FIGO (Fédération International de Gynécologie et d’Obstétrique) abhängig, die trotz erheblicher Ungenauigkeiten bei der klinischen Stadieneinteilung weiterhin aufgrund klinischer Untersuchungsbefunde erfolgt. Obwohl bildgebende Verfahren nach wie vor für die Stadieneinteilung nicht vorgesehen sind, wird im kürzlich erschienen revidierten Stagingsystem der FIGO zum ersten Mal die Verwendung moderner Schnittbilddiagnostik (MRT und CT) befürwortet. Die MRT ermöglicht dank ihres hohen Weichteilkontrasts ein ausgezeichnetes nichtinvasives Staging des Zervixkarzinoms mit direkter Tumordarstellung sowie einer Prognoseabschätzung anhand bildmorphologischer Faktoren. Nach Ergebnissen in der Literatur beträgt die Genauigkeit der MRT bei der präoperativen Abschätzung der Tumorgröße sowie der Differenzierung operabler Zervixkarzinome von fortgeschrittenen Karzinomen 93%. Sie wird daher nicht nur als das Verfahren der Wahl zur diagnostischen Beurteilung ab FIGO-Stadium IB1 angesehen, sondern auch zur Strahlentherapieplanung sowie zum Rezidivausschluss im Rahmen der Nachsorge. In der folgenden Arbeit geben wir einen Überblick über die Rolle der MRT bei der präoperativen Stadieneinteilung des Zervixkarzinoms.

Abstract

The treatment of uterine cervical carcinoma is largely dependent on the tumor stage. Despite significant inaccuracies in the clinical examination, uterine cervical cancer remains the only gynecological form of cancer still largely staged according to clinical findings. Although imaging is still not included in the staging the recently published revised FIGO (Fédération International de Gynécologie et d’Obstétrique) system encourages the use of modern cross-sectional imaging (magnetic resonance imaging MRI and computed tomography CT). Due to its high soft tissue contrast MRI allows excellent non-invasive assessment of the cervix with direct tumor delineation as well as assessment of the prognosis based on morphological factors. Studies in the literature report an accuracy of 93% for MRI in the preoperative assessment of tumor size and in the differentiation of operable from advanced cervical cancer. Therefore MRI is considered to be the optimal modality for diagnostic evaluation starting from FIGO stage IB1, for radiation therapy planning, and for exclusion of recurrence in follow-up. In this paper we give an overview of the role of magnetic resonance imaging in preoperative staging of uterine cervical cancer.

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  1. Klinik für Radiologie, Charité-Universitätsmedizin Berlin, Campus Charité Mitte, Charitéplatz 1, 10117, Berlin, Deutschland

    F. Collettini & B. Hamm

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  1. F. Collettini
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  2. B. Hamm
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Correspondence to F. Collettini.

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Collettini, F., Hamm, B. Zervixkarzinom. Radiologe 51, 589–595 (2011). https://doi.org/10.1007/s00117-010-2119-1

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