{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T18:42:48Z","timestamp":1791484968878,"version":"4.3.4"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T00:00:00Z","timestamp":1759536000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T00:00:00Z","timestamp":1759536000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Radiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the impact of MRI-defined bladder wall invasion from uterine cervical cancer (CC) on disease recurrence and overall survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>IRB-approved multicenter retrospective study including women who underwent staging MRI for histologically confirmed CC (Jan 2015\u2013Dec 2020). Image analysis was independently performed by two radiologists. Bladder wall invasion was diagnosed if \u2265\u20093 of the following criteria were met: loss of the cervix-bladder fat plane, bladder wall thickening, loss of bladder wall T2-hypointensity, and presence of endoluminal tumor growth. MRI findings were compared with endoscopy\/cytology. The impact of MRI-defined bladder wall invasion on tumor recurrence and survival was assessed using logistic regression. Survival curves were compared using the log-rank test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We included 214 women with a median age of 55 (IQR 47\u201365) years. MRI-defined bladder wall invasion was observed in 21.5% of patients. Cystoscopy revealed bladder mucosal infiltration in 7.0% of patients, all of whom demonstrated MRI-defined bladder wall invasion. No patients without MRI-defined bladder wall invasion showed mucosal infiltration on cystoscopy\/cytology. The median follow-up was 32 months: 46.7% of patients had recurrence, and 23.4% had CC-related death. On logistic regression, MRI-defined bladder wall invasion was an independent risk factor for tumor recurrence (OR 2.24,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.047) and mortality (OR 3.55,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006), whereas cystoscopy-defined bladder mucosa infiltration was not. The log-rank test demonstrated a significant difference in survival between patients with and without MRI-defined bladder wall invasion (\n                      <jats:italic>\u03c7<\/jats:italic>\n                      \u00b2\u2009=\u200915.40,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MRI-defined bladder wall invasion represents an independent negative prognostic factor in patients with cervical cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Question<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>The prognostic significance of MRI-defined bladder wall invasion in patients with cervical cancer remains unclear with respect to disease recurrence and survival<\/jats:italic>\n                      .\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Findings<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>Bladder wall invasion identified on MRI is an independent predictor of tumor recurrence and tumor-specific mortality, whereas mucosal infiltration detected via cystoscopy is not<\/jats:italic>\n                      .\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Clinical relevance<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>MRI can safely replace cystoscopy in the preoperative staging of patients with uterine cervical cancer. This approach can reduce costs and expedite the staging process<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s00330-025-12039-5","type":"journal-article","created":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T11:02:11Z","timestamp":1759575731000},"page":"3033-3042","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Preoperative staging of cervical cancer: time to shift from cystoscopy to MRI"],"prefix":"10.1007","volume":"36","author":[{"given":"Matteo","family":"Bonatti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Valletta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"D\u2019Erme","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Dolciami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Chianura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro Paolo Maria","family":"Azzaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Innocenzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicol\u00f2","family":"Bizzarri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Vingiani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Negri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Steinkasserer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Notaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Vanzo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Magri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedetta","family":"Gui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evis","family":"Sala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9926-760X","authenticated-orcid":false,"given":"Giacomo","family":"Avesani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,4]]},"reference":[{"key":"12039_CR1","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1002\/ijgo.12608","volume":"143","author":"N Bhatla","year":"2018","unstructured":"Bhatla N, Denny L (2018) FIGO Cancer Report 2018. 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However, no complex statistical methods were necessary for this paper.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statistics and biometry"}},{"value":"Written informed consent was obtained a posteriori from patients who could be contacted. For patients who were deceased or could not be reached despite reasonable attempts, the ethics committee granted a waiver of informed consent based on the retrospective nature of the study.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Institutional Review Board approval was obtained (Ethical Committee for Clinical Experimentation of the Autonomous Province of Bolzano, Protocol 64-2024). The study was conducted in accordance with the Declaration of Helsinki.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"None.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Study subjects or cohorts overlap"}},{"order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}