Short summary

To explore the clinical relevance of the new hybrid PET/MRI in primary staging of cervical cancer, control after curative intended radiochemotherapy and restaging recurrence of cervical cancer.

Rationale

At present PET/CT in combination with MRI of the pelvis is recommended by the Danish national guidelines for initial staging of cervical cancer with FIGO stage 1B1 and above .  

Recently hybrid PET/MRI scanners were introduced combining the functional ability of PET with the superior soft-tissue contrast and spatial resolution of MRI offering the possibility of improved diagnostic accuracy in a single diagnostic test. Being a new modality the number of published studies is still very limited and well-powered prospective studies providing evidence for clinical impact in high demand.  The current studies compared either PET/MRI vs. MRI alone or PET/MRI vs. PET/CT, and neither explored the potential synergy in simultaneous whole body PET/MRI performance to separate whole body PET/CT and MRI pelvis witch is the current diagnostic work up in cervical cancer patients at Odense University Hospital (OUH). As PET/CT and MRI performed separately are already part of the diagnostic work up in cervical cancer, and that PET/MRI holds potential for providing additional diagnostic value in selected patients, well powered prospective studies are in demand to further explore this and to identify the patients who will benefit from changing from PET/CT and MRI to the combined modality. In addition, a prospective comparative study designed with respect to patient comfort and patient friendly scan times will allow for exploring the promising tools of dynamic MRI in synergy with quantitative PET parameters as prognostic marker and for improved early detection of potential disease recurrence.

The aim of the study is to evaluate the diagnostic value of simultaneous PET/MR in staging and restaging of cervical cancer compared to standard with PET/CT and MR pelvic.

Description of the cohort

Women with suspected or comfirmed primary cervical cancer > FIGO stage 1b or suspected/confirmed recurrence or in routine follow up after standard radiotherapy treatment. 

Data and biological material

Data from PET/CT, MR pelvis and PET/MR. The following patient characteristics: age, ethnicity, clinical staging (DGCG guidelines), tumor histology, tumor grade and size, and number and location of metastatic lymph nodes.

Collaborating researchers and departments

Department of Gyaecology, OUH

•  Kirsten Jochumsen, senior consultant

Department of Oncology, OUH:

•  Gitte Bettina Nyvang, senior consultant
•  Carsten Brink, physicist, PhD, professor
•  Tine Schytte, senior consultant, PhD, Associated professor

Department of Radiology, OUH:

•  Jon Thor Asmussen, senior consultant

Department of Nuclear Medicine, OUH:

•  Thomas Lund Anderen, physicist, PhD
•  Oke Gerke, statistician, professor