Magnetic resonance imaging in the initial staging of cervical cancer: updating the 2021 ESUR guidelines

Solopova A.E., Ukraintsev N.I., Rubtsova N.A.

1) Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of the Russian Federation, Moscow, Russia; 2) A.S. Loginov Moscow Clinical Research and Practical Center, Moscow Healthcare Department, Moscow, Russia; 3) Р.A. Herzen Moscow Oncology Research Institute, Branch, National Medical Radiology Research Center, Ministry of Health of the Russian Federation, Moscow, Russia
The paper presents the European Society for Urogenital Radiology (ESUR) guidelines for the radiodiagnosis
of cervical cancer (CC) and current concepts in its primary staging, by taking into account the main characteristics of the tumor and the possibilities of treating CC. Objective of this review – to systematize relevant scientific data on the possibilities and prospects for developing medical imaging techniques in CC. The ESUR guidelines standardize and promote the higher efficiency of using radiodiagnostic techniques for CC. The updated ESUR guidelines consider into account all the changes given in the FIGO classification in accordance of the 2009/2018 revisions and the 8th edition of the Timor-Node-Metastasis (TNM) staging system. In accordance with the updated FIGO system, the paper shows a significant role and place of MRI in CC before, during, and after antitumor treatment. Clinical assessment of the neoplasm is the basis of the FIGO classification as before. Modern instrumental diagnosis makes it possible to increase the objectivity of estimating the prevalence of the tumor process in the preoperative stage. This enables radiodiagnostic techniques to be used as an additional tool in clinical staging. The ESUR clarifies the criteria for primary staging and for planning anticancer therapy. The paper considers clinical cases with an emphasis on MRI staging criteria, evaluation of the efficiency of treatment and prognosis, diagnosis of recurrent CC. The review highlights the possibilities for the development of medical imaging, which are aimed at using hybrid methods for imaging and radiomics in the staging of advanced CC.
Conclusion: The current scientific data on urogenital radiology are of particular interest for radiation diagnosis and gynecologic oncology and serve as the basis for clinical application.


cervical cancer
magnetic resonance imaging
MRI assessment system
diffusion-weighted imaging
neoplasm staging
neoplasm recurrence


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Received 13.07.2022

Accepted 08.08.2022

About the Authors

Alina E. Solopova, MD, PhD, Associate Professor, Leading Researcher, Department of Radiology, Academician V.I. Kulakov National Medical Research Center for Obstetrics,
Gynecology and Perinatology,,, 117997, Russia, Moscow, Academician Oparin str., 4.
Nikita I. Ukraintsev, MD, resident doctor, Loginov Moscow Clinical Scientific Center, Moscow Healthcare Department,,
111123, Russia, Moscow, Shosse Entuziastov, 86.
Natalia A. Rubtsova, Dr. Med. Sci., Professor, Head of the Department of Radiology, P.A. Hertsen Moscow Oncological Center,,
125284, Russia, Moscow, 2nd Botkinsky pr., 3.

Authors' contributions: Solopova A.E. – analysis of sources, writing the article, selection of images; Ukraintsev N.I. – analysis of current literature, writing the article, selection of images; Rubtsova N.A. – peer-reviewing and editing the text of the article, assistance in adapting the recommendations.
Conflicts of interest: The authors declare that there are no conflicts of interest regarding this publication.
Funding: The investigation has not been sponsored.
For citation: Solopova A.E., Ukraintsev N.I., Rubtsova N.A. Magnetic resonance imaging in the initial staging of cervical cancer: updating the 2021 ESUR guidelines.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2022; 8: 36-46 (in Russian)

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