Society of Abdominal Radiology (SAR), Uterine and Ovarian Cancer Diseased Focused Panel (DFP) cervical cancer staging MRI template
Study: MRI Pelvis without and with contrast Clinical Information/History: [free text] Comparison: [free text] Technique: Prior to and following the uneventful intravenous administration of contrast, T1 and T2 weighted images in multiple planes were obtained through the pelvis. Prior to contrast administration, diffusion-weighted images were obtained through the pelvis. Findings: UTERUS: Measures [ ] x [ ] x [ ] cm [Describe other uterine findings, excluding the tumor.] TUMOR SITE: [Endocervical tumor/exophytic; arises from the anterior or the posterior lip or circumferential; involves the entire cervix.] TUMOR SIZE: [Give 3 dimensions (eg: 2 cm x 2 cm x 5 cm) UTERINE INVASION: [absent/present] [Describe location, lower uterus, body, fundus] PARAMETRIAL INVASION: [absent/present -- OR -- describe how certain you are: suspicious for/possible/less likely/unlikely] [Describe location] VAGINAL INVASION: [none/upper 2/3 of the vagina/lower 1/3 of the vagina] TUMOR EXTENSION: [none/right or left pelvic side wall/bladder/rectum]; [presence/absence of ureteral dilatation]. ADDITIONAL COMMENTS: [Add any specific comments related to the tumor here if appropriate] OVARIES: The ovaries are [not visualized/visualized] and are [normal/abnormal] in appearance. [Right Ovary measures # x # x #cm and left ovary measures # x # x #cm.] [If abnormal describe.] LYMPH NODES: There are [no/few/many] lymph nodes; [The largest pelvic lymph node is located (give location) and measures (give size).] [The largest para-aortic lymph node measures (give size)]. These lymph nodes are [likely/possibly/less likely to be/unlikely to be] metastatic in nature. ADDITIONAL FINDINGS: [None; presence/absence pelvic fluid; presence/absence pelvic peritoneal implants; other findings] BONES: [No aggressive bone lesions] Impression: 1. Cervical cancer [ summarize the cervical tumor, including extent of invasion and provide your impression of whether there are suspicious lymph nodes]. For information on suggested MRI imaging protocols, please visit the UOC DFP website at: : http://www.abdominalradiology.org/?DFPUOC
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