LAUSR

Cervical cancer is the third most commonly diagnosed cancer and the fourth leading cause of cancer death in females worldwide. The Gynecologic Oncology Committee of the International Federation of Gynecology and Obstetrics (FIGO) revised the cervical cancer staging guidelines in 2018, allowing staging based on imaging and pathological findings. Imaging parameters derived from functional magnetic resonance imaging (MRI) techniques and positron emission tomography / computed tomography (PET/CT) are useful in detection, characterization and staging of cervical cancers, monitoring therapy, disease recurrence, and surveillance. Integrated PET/MRI has transitioned from a research tool to clinical practice and provides simultaneous PET and MRI data in a single examination. PET/MRI-derived functional parameters like SUVmax, ADCmean, and ADCmin are used to study tumor aggressiveness, treatment response, and prognosis in cervical cancer. Higher SUVmax predicts nodal metastatic potential and disease recurrence. Lower ADCmean values indicate shorter disease-free survival (DFS). High SUVmax combined with low ADCmin of primary tumor is an independent prognostic factor in the prediction of DFS and overall survival (OS). Yilidirim et al reported a significant correlation of SUVmax and ADCmean of primary tumor with tumor size, treatment response, and propensity for lymph node metastasis. A significant increase in SUVmax values and decrease in ADCmin were observed in poorly differentiated tumors. Area under curve analysis (AUC) indicated that SUVmax is superior to ADCmin for lymph node metastasis, while ADCmin has better potential in differentiation of pathological grades. ADCmin values were lower in tumors with nodal metastasis. 5