Imaging of the prostate with emphasis on evlauation for carcinoma, gains precedence as the curability and disease free survival rates are high. MRI with PIRADS protocol brings uniformity and enables the surgeons and radiologists to converse with great clarity and better stratification of the disease status.
Imaging of the prostate with emphasis on evlauation for carcinoma, gains precedence as the curability and disease free survival rates are high. MRI with PIRADS protocol brings uniformity and enables the surgeons and radiologists to converse with great clarity and better stratification of the disease status.
Ultrasound Elastography is a new imaging technique that allows a noninvasive estimation and imaging of tissue elasticity distribution within biological tissues using conventional, Real Time Ultrasound equipment with modified software. It can be viewed as an electronic palpation of tissues. Introduced by Ophir et al in 1991, it subsequently evolved into a Real Time Imaging tool.
Management of cacrinoma cervix: Techniques of radiotherapy (2D conventional, 3D Conformal radiotherapy (3DCRT) and IMRT with a review of various contouring guidelines.
A brief overview of Imaging of urinary bladder and urethra for medical students and residents with commonly encountered benign and neoplastic conditions of lower urinary tract.
Imaging assessment of malignant focal and diffuse liver lesions from Ultrasound to Mri with overview of interventional modalities and diagnostic snippets,
Ultrasound Elastography is a new imaging technique that allows a noninvasive estimation and imaging of tissue elasticity distribution within biological tissues using conventional, Real Time Ultrasound equipment with modified software. It can be viewed as an electronic palpation of tissues. Introduced by Ophir et al in 1991, it subsequently evolved into a Real Time Imaging tool.
Management of cacrinoma cervix: Techniques of radiotherapy (2D conventional, 3D Conformal radiotherapy (3DCRT) and IMRT with a review of various contouring guidelines.
A brief overview of Imaging of urinary bladder and urethra for medical students and residents with commonly encountered benign and neoplastic conditions of lower urinary tract.
Imaging assessment of malignant focal and diffuse liver lesions from Ultrasound to Mri with overview of interventional modalities and diagnostic snippets,
Cervical cancer kills 270,000 women each year — mainly women in the developing world and in the prime of their productive lives. But cervical cancer is preventable by screening asymptomatic women for precancerous cervical lesions and treating the lesions before they progress to invasive disease. In other words, those deaths are largely preventable. Studies suggest that even if a woman were screened for cervical cancer only once in her lifetime between the ages of 30 and 40, her risk of cancer would be reduced by 25-36%.
These slides are from versions of a talk I gave at ESTRO in 2014 and again in Lille in 2015.
The talk aims to explain the importance of correctly defining the CTV with respect to nodes in curative radiotherapy planning.
The lecture makes some important points about the function of lymph glands and their potential to act as stem cell 'rests' for malignant cells: this fact might explain whilst lymph node failure rates don't necessarily equate to disease failure rates.
The lecture then goes on to emphasise the utility of the best imaging technologies may more accurately identify involved nodes.
Shrinking fields with confidence may be the best way to reduce radiation toxicity.
retroperitoneal tumors esp. retroperitoneal sarcoma is most challenging condition to treat in retroperitoneal region inspite of using all treatment modalities.here is brief description of its management acc. to nccn , and other text book ref.
A multidisciplinary approach that includes surgery, medical oncology, and radiation oncology is required for optimal treatment of patients with rectal cancer
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
For Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #Girls
Imaging in diagnosis and treatment of carcinoma cervix
1. Role of Imaging
in
Diagnosis and Treatment
of
Carcinoma Cervix
Presenter : Jagadesan Pandjatcharam
Moderators : Assoc.Prof. D.N. Sharma
: Assoc.Prof. Sanjay Thulkar
Dr.BRA IRCH, AIIMS, New Delhi, 2009
2. Introduction
• Cancer cervix is the second most common cancer in the
world among females [Globocan 2002]
• Commonest Cancer in females in most part of India
• It ranks second in Delhi [NCRP]
• Highest incidence in Chennai
• 30-50 years
* Global Cancer Statistics,CA Cancer J Clin 2005;55;74-108
** National Cancer Registry Programme,India 2005
4. Risk Factors
• Human Papillomaviruses-Types16,18,31,33
• Young age at first intercourse (<16 years)
• Multiple sexual partners
• High parity
• Low socioeconomic status
• Poor Sexual Hygiene
» Eur J Gynaecol Oncol. 1990;11(1):51-6
5. Prognostic factors
Tumor size
Lymph node metastases
Stromal invasion
Lympho-Vascular space invasion
Hemoglobin status
6. Stages FIGO Staging [1994]
Confined to cervix – microscopic (1A) or clinical (1B)
I
I A1 Less than 3 mm depth of invasion, <7 mm horizontal spread
I A2 3-5 mm depth of invasion
I B1 >5 mm depth of invasion, macroscopically visible
I B2 > 4 cm of primary tumor size
Invasion of upper vagina (2A) or parametrium (2B)
II*
Invasion of lower vagina (3A), pelvic wall/ hydronephrosis (3B)
III
Invasion of UB/ rectum (4A) or distant metastases (4B)
IV
*modified in FIGO 2010
7. Errors in FIGO Staging
FIGO staging Errors in comparison to
surgical staging
I
20-30%
II 23%
III 65-90%
IV
-Obs&Gyn,1995;86((1):43-5
-Vidaurreta J et al Gynecol Oncol 1999;75:366–71
8. FIGO Imaging tests
• IVP
• Barium enema
• Chest x-ray
• Cross sectional imaging is not mentioned, but
it is increasingly used in the form of
– USG / CT / MRI
13. Computed Tomography
• Advantages
– Detection of parametrial extension, local organ
invasion, metastases, renal abnormality
– Replace IVP
• Disadvantages
– Primary tumor may not be seen
15. Computed Tomography
• Parametrial invasion
– Streakiness
– Extension of mass
– Encasement of ureter
– Thickening of uterosacral
ligament
16. Computed Tomography
• Pelvic wall invasion*
– Tumor within 3 mm from
muscles
– Invasion of muscles, bone
– Vascular encasement
• Invasion of UB/ rectum
– Loss of fat planes
– Wall thickening, irregularity
*H.K. Pannu, RadioGraphics, 2001;21:1155-1168
33. Positron Emission Tomography
• Scanning of the radioisotope activity in the
body from the head to mid-thighs
• Functional scan as it reflects the amount of
function related to the substance to which the
isotope is tagged
• Commonly used 2-F18-Fluoro,2-Deoxy Glucose
34. Positron Emission Tomography
• Advantages
– Pelvic and Para-aortic nodes
– Distant visceral metastases
– SUV*
• Disadvantages
– Poor local tumor description
– Poor visibility of local extension
– Longer scanning time
Kidd EA, Cancer. 2007 Oct 15;110(8):1738-44
40. PET Fusion
Sensitivity Specificity
PET-CT 44.1% 93.9%
PET-MR 54.2% 92.7%
79 pts had lymphadenectomy
Kim SK et al, Eur J Cancer. 2009 Aug;45(12):2103-9.
41.
42. Prognostic use of PET
• 20 patients of II and III were studied for pre
treatment SUVmax of the primary tumor
• Responses were related to the uptake
• There is a trend of poor response to standard
therapy with increasing SUV.
MD Thesis of Jagadesan P, Jun 2009 under Dr D.N.Sharma
43. SUV comparisons between different responses
FIGO stage No. of patients Complete Partial Responders(4)
responders(16)
IIa 0
Mean 7.90 9.96
IIb 8 Minimum 2.90 5.40
IIIa 0 Maximum 12.60 22.40
Standard ±3.02 ±8.30
IIIb 12
deviation
44. Stages Revised FIGO Staging - w.e.f Jan 2009
Confined to cervix – microscopic (1A) or clinical (1B)
I
I A1 Less than 3 mm depth of invasion, <7 mm horizontal spread
I A2 3-5 mm depth of invasion
I B1 >5 mm depth of invasion, macroscopically visible
I B2 > 4 cm of primary tumor size
Invasion of upper vagina (2A) or parametrium (2B)
II
II A1 Mass ≤ 4.0cm involving upper 2/3 vagina
II A2 Mass ≥ 4.0cm involving upper 2/3 vagina
Invasion of lower vagina (3A), pelvic wall/ hydronephrosis (3B)
III
Invasion of UB/ rectum (4A) or distant metastases (4B)
IV
46. Can MRI/CT replace endoscopic evaluation?
• CT and MRI have good sensitivity and
specificity in detecting local invasion into
bladder
• NPV of 100% with MR as well as CT imaging
47. AIIMS - IRCH Attribute All patients Patients with
on CT scan
Patients with
bladder invasion bladder invasion
on Cystoscopy
study No. of patients
Median age (yrs)
305
50
43 [14.1%]
45
17 [5.6%]
48
Age range (yrs) 25-85 30-77 30-75
IB 36 2 0
Distribution of bladder IIA 9 0 0
IIB 65 3 1
invasion in cervical cancer
IIIA 10 2 1
patients IIIB 139 26 11
Effectiveness of CT scan in IVA 17 6 4
IVB
detecting bladder invasion 9 1 1
Unknown 20 3 0
Histopathology- 283 39 15
Squamous
Adeno 14 4 2
Others 8 0 0
Grade- Well differentiated 71 5 1
Mod. differentiated 130 8 4
Poorly differentiated 84 25 11
Unknown 20 5 1
52. Early stage
– Ia1, Ia2 • Wertheim’s hysterectomy
– Ib1, Ib2 Type III hysterectomy
– IIa • TAH+BSO
• Pelvic lymphadenectomy
• ± Para-aortic LN sampling
53. Advanced stages
• IB2 • Concurrent Radiation
• Bulky IIA [>4cm] with chemotherapy
• II B to IV A – EBRT plus CISPLATIN
– Intra-cavitary
brachytherapy
Palliation with chemotherapy and/or radiation in late metastatic disease
56. Fluoroscopy
Demarcate the
target areas in
relation to bony
anatomy
Borders of the field
varies according to
the involved levels
of lymph node
stations
60. MRI
• Better target delineation
• Need to fuse with CT to obtain
Dosimetric Info.
• USPIO [Ultrasmall Super-
Paramagnetic Iron Oxide ]
used to identify involved
nodes*
*Dinniwell et al, IJROBP, 2009 Jul 1;74(3):844-51
61. PET
Better sensitivity in
detection of pelvic
and para-aortic nodes
Being tried in
treatment planning*
*Mutic S et aI, Int J Radiat Oncol Biol Phys. 2003 Jan 1;55(1):28-35
62. Brachytherapy- ICRT
• CT
• MRI
– GEC-ESTRO guidelines for
image based brachytherapy
– Helps in accurate description
of OARs [organ at risk]
• PET*
*Int J Radiat Oncol Biol Phys. 2007 Jan 1;67(1):91-6
71. Image guided brachytherapy - EBM
• 35 patients underwent catheter insertion
• CT imaging confirmed accurate placement within the uterine canal
in all cases[100%] {perforation rate of 10% with unaided insertions}
• Visualizing patient anatomy during insertion altered the selection of
tandem length and angle in 49% of cases, resulting in improved
applicator matching to anatomy.
• Average insertion time significantly decreased from 34 to 26
minutes (p=0.01)
• Requests for assistance from gynecologic surgical oncology declined
from 38% to 5.7% of procedures
Davidson MT et al, Brachytherapy. 2008 Jul-Sep;7(3):248-53
72. Conclusions
• Though cervical cancer is a clinically staged disease, imaging plays
an important role in deciding its management
• Imaging is helpful in describing local disease extent and nodal
involvement which are important prognostic factors
• CT scan is a good imaging modality for pre-treatment evaluation as
it is relatively easily available with good sensitivity and specificity
• MRI is the best option, presently available in evaluating cervical
cancer
• PET scan is useful in detecting nodal spread
73. Conclusions
• Image-Guided methods
– It is needed for disease assessment, provisional treatment
planning ("pre-planning"), applicator placement and
reconstruction
• Image BASED processes
– contouring, definitive treatment planning and quality control of
dose delivery
• Image-Guided and Image-Based radiation treatments are
aimed at better target localization and effective sparing of
organs at risk [OAR].
76. Role of imaging
• Image-Guidance
– It is needed for disease assessment, provisional treatment planning
("pre-planning"), applicator placement and reconstruction
• Image BASED processes
– contouring, definitive treatment planning and quality control of dose
delivery
• MRI in staging primary - IB and above
• PET-CT in staging the Nodes
• CT is a cheap alternative to MRI and PET-CT
78. GEC-ESTRO guidelines for reporting
IGBT
• DVH parameters for GTV, HR CTV and IR CTV are the minimum dose
delivered to 90 and 100% of the respective volume: D90, D100.
• The volume, which is enclosed by 150 or 200% of the prescribed dose
(V150, V200), is recommended for overall assessment of high dose
volumes.
• V100 is recommended for quality assessment only within a given
treatment schedule.
• For Organs at Risk (OAR) the minimum dose in the most irradiated tissue
volume is recommended for reporting: 0.1, 1, and 2 cm3; optional 5 and
10 cm3.
80. Recurrent disease
• Most common within two years
• Sites
– Vaginal vault
– Lymph nodes
– Liver/ lung metastases
• Imaging
– MRI is preferred
– High sensitivity, poor specificity
• Early RT changes/ infection can not be
differentiated from tumor
82. Selectron OT, Dr.BRA IRCH, Department of Radiation
Oncology (Radiotherapy), AIIMS
83. Dose reduction to normal structures
Rectal dose (of Pt A) Bladder dose (of Pt A)
ICRT 60-70% 70-80%
Interstitial 20-25% 20-25%
Practised in Department of Radiation
Oncology, AIIMS
Editor's Notes
Lymphatic metastases were found in 34% of women; 13% had common iliac nodal metastases, and 9% had paraortic nodal metastases. Early invasive cervical cancer: MRI and CT predictors of lymphatic metastases in the ACRIN 6651/GOG 183 intergroup studyGynecologic OncologyVolume 112, Issue 1, January 2009, Pages 95-103
Cross-sectional imaging provide the tumor size and the lymph node status which are important prognostic factors
Figure 6a. Stage IIb cervical carcinoma. Sagittal (a) and axial (b)T2-weighted MR images show that the cervix is almost entirely replaced by a slightly hyperintense mass. The tumor protrudes into the parametrium bilaterally (arrowheads in b); however, it does not reach the pelvic wall. Hydrometra, which is caused by the obstructed internal cervical os, is also noted (arrow in a)
Figure 7b. Stage IIIa cervical carcinoma. (a)Sagittal T2-weighted MR image shows a slightly hyperintense, exophytic, solid mass that extends along the anterior vaginal wall and reaches the lower one-third of the vagina (arrow). (b) Axial T2-weighted MR image shows that the low signal intensity of the anterior vaginal wall is partly disrupted (arrowheads) and the fatty tissue between the mass and the posterior bladder wall has disappeared. However, the mass does not infiltrate the vesical mucosa.
Figure 8b. Stage IIIb cervical carcinoma. (a)Sagittal T2-weighted MR image shows a slightly hyperintense, large, solid mass that extends from the uterine cervix to the lower part of the uterine body. It also extends to the lower one-third of the anterior vaginal wall (arrow). (b) Axial T2-weighted MR image shows that the tumor also reaches the left posterior wall of the bladder, although the thinned vesical muscular layer remains (arrowheads)
Figure 9. Stage IVa cervical carcinoma. Sagittal T2-weighted MR image shows a hypointense mass that occupies the uterine cervix and invades the vaginal wall anteriorly. At the level of the vaginal extension, the tumor reaches the mucosa of the posterior vesical wall (arrows).
Figure 10a. Stage IVb cervical carcinoma. (a)Sagittal T2-weighted MR image shows a large mass in the uterine cervix. (b, c) CT scans show metastases of paraaortic lymph nodes (arrows in b) and hematogenous hepatic metastases (c). These findings are classified as stage IVb disease