Functional Magnetic Resonance Imaging in Cervical Cancer Diagnosis and Treatment.

Cervical Cancer is the fourth most common cancer in women worldwide. Treatment with chemoradiotherapy followed by brachytherapy achieves high local control, but recurrence with metastatic disease impacts survival. This highlights the need for predictive and prognostic biomarkers identifying populations at risk of poorer treatment response and survival. Magnetic resonance imaging (MRI) is routinely used in cervical cancer and is a potential source for biomarkers. Functional MRI (fMRI) can characterise tumour beyond anatomical MRI, which is limited to the assessment of morphology. This review summarises fMRI techniques used in cervical cancer and examines the role of fMRI parameters as predictive or prognostic biomarkers. Different techniques characterise different tumour factors, which helps to explain the variation in patient outcomes. These can impact simultaneously on outcomes, making biomarker identification challenging. Most studies are small, focussing on single MRI techniques, which raises the need to investigate combined fMRI approaches for a more holistic characterisation of tumour. [Display omitted] • fMRI has the potential to provide non-invasive biomarkers for cervical cancer. • Different fMRI techniques characterise tumour properties including cellularity, necrosis, vascular permeability and oxygenation. • Changes in quantitative fMRI parameters in treatment can correlate with tumour response and survival. • Combining fMRI techniques allows for more holistic characterisation of tumour properties in the context of patient treatment response and survival. [ABSTRACT FROM AUTHOR]