If you have cervical cancer, your doctor may recommend you undergo various imaging studies such as a magnetic resonance imaging (MRI) or a computed tomography (CT) scan. These studies can show whether or not the cancer has spread beyond the cervix. A chest x-ray may also be done to determine if the cancer has spread to the lungs, which is quite unlikely unless it is very advanced.
Computed Tomography (CT)
A CT scan is an x-ray that produces highly detailed cross-sectional images of the body. Unlike conventional X-rays, CT scanners do not only take one picture but multiple pictures while it rotates around your body. The images are then digitally combined to show a cross-section of your body. A CT scan can indicate if the cancer has spread to the lymph nodes of the abdomen or pelvis or into other organs such as the liver or lungs.
CT scanners are generally described as having a donut shape, with the long narrow table in the center. It is important to lie very still on the table while getting the scan, to ensure that the images are not warped. A CT scan normally takes longer than a regular x-ray, due to all the technical work that is required for the computer to take the cross-sectional images. However, the best thing to do is just try to relax if you start to feel confined.
The normal procedure is that, before the test, you will have to drink a pint or two of oral contrast liquid. This liquid is used to allow the images to be reflected and to outline the structures in the body. You may receive the contrast liquid intravenously instead of orally. The IV contrast might make you feel a bit warm and cause some redness on your skin, but this should be temporary.
Some people are allergic to the contrast dye and may develop hives. In rare cases, a person might have a serious reaction, such as trouble breathing or low blood pressure. If this is something you or your doctor is concerned about, you may be given certain medicine to prevent these allergic reactions. This is why it is important that you tell your doctor if you have had an allergic reaction to contrast fluids in the past.
A CT scan may used to guide a biopsy needle into an area where it is suspected that cancer has spread. During this procedure, the patient stays on the scanning table while a radiologist directs a biopsy needle to the location of the cancerous mass. The scan will be repeated until the doctor is sure that the needle is in the mass. A sample of tissue may be removed and examined by a lab.
Magnetic Resonance Imaging (MRI)
An MRI scan uses high-frequency radio waves and strong magnets to take pictures of your body. The energy that resonates from the radio waves is absorbed by the body and released to form specific patterns. A computer then translates the radio wave patterns that are given off by the tissues and creates a detailed image of certain parts of the body. Not only can an MRI produce cross-sectional images like a CT scanner does, but it can also produce parallel images of the length of your body.
MRI images may be used to examine pelvic tumors or to detect cancer that may have spread to the brain or spinal cord.
Sometimes, a contrast liquid may be injected the same as with CT scans, but this done less frequently. An MRI scan can take longer than a CT scan; sometimes they last for an hour. For the MRI, you will lie inside a tube-like apparatus, which many people find confining. There are “open” type MRI machines that are less confining, which may be a better option for patients who suffer from claustrophobia. However, you need to be aware that the images from these machines may not be as clear as a traditional MRI machine.
The other problem with MRI machines is that they sometimes make a thumping noise that some people find irritating. But the good news is that sometimes you will be provided with headphones during the procedure so that you can listen to music, which may help to block out the noise. You may also find a mild sedative to be helpful at calming your nerves.
Intravenous urography, sometimes known as intravenous pyelogram, is an x-ray taken of the urinary system after a special dye is injected into a vein. The kidneys will remove this dye from the bloodstream and pass it through the ureters, to empty into the bladder. This test is used to find any abnormalities in the urinary tract, including changes that may be the result of the cancer spreading to the pelvic lymph nodes. This may cause compression or blockage in the ureters. However, this test is rarely used for patients with cervical cancer, as a CT or MRI is deemed sufficient.
Positron Emission Tomography
Positron emission tomography is a scan that uses glucose containing radioactive atoms, which is absorbed by cancer cells in the body. A special camera is used to detect radioactivity from the cancer cells, which can indicate whether the cancer has spread to the lymph nodes. These scans may be helpful if your doctor suspects that the cancer has spread but is unsure where. They can also be used in place of other x-rays because they can scan the whole body. This is why they are sometimes combined with the CT scan, as certain machines can do both scans at the same time. This test is rarely used for cervical cancer patients in early stages, however may be used if the disease is more advanced.