Aspects post-thérapeutiques du cancer du col utérin

Chemoradiation therapy combined with brachytherapy changed dramatically the prognosis of advanced uterine cervical cancer. MRI is a key examination to determine treatment response evaluation. Nevertheless, interpretation may be challenging due to post-therapeutic changes and inflammatory lesions seen on MRI, which can lead to false positives and useless surgical treatment. Diffusion-weighted imaging (DWI) sequences may improve MRI specificity, and reduce the number of false positives. Follow-up MRI may also be an option in case if benign post-treatment changes are suspected. It is mandatory to detect tumor recurrences. Systematic imaging follow-up is not recommended, except when trachelectomy has been performed. MRI is required in case of clinical symptoms. PET-CT remains an accurate examination to detect and stage recurrences before pelvic exenteration.