Imaging in Carcinoma Cervix Staging, Follow-up, and Surveillance: A Review

Abstract Cervical cancer is a significant health concern globally and is the second most common cancer among women in India. Progress in awareness, hygiene, healthcare infrastructure, and interventions has led to decreasing incidence and mortality rates of cervical cancer, but remains alarmingly high, where delayed presentation is the most common reason. Until recently, cervical cancer was staged clinically with minimal investigations like ultrasonography (USG) and cystoscopy, leading to suboptimal evaluation and staging. In 2018, FIGO incorporated ‘Imaging’ for staging of cervical cancer to accurately delineate disease for treatment planning, further validated by the 2021 update. USG is often the first imaging test utilized, while magnetic resonance imaging (MRI) is the imaging modality of choice to delineate disease extent. It has the highest specificity, sensitivity, and accuracy in detecting the parametrial and stromal invasion. MRI is also used for treatment planning and response assessment. Contrast-enhanced computed tomography and positron emission tomography scans are reserved for distant staging. This review article aims to discuss the role of imaging in diagnosis, pretreatment staging, treatment planning, and surveillance.