Multi-model quantitative MRI of uterine cancers in precision medicine’s era—a narrative review

Abstract Purpose This review aims to summarize the current applications of quantitative MRI biomarkers in the staging, treatment response evaluation, and prognostication of endometrial (EC) and cervical cancer (CC). By focusing on functional imaging techniques, we explore how these biomarkers enhanc...

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Main Authors: Marco Gennarini, Rossella Canese, Silvia Capuani, Valentina Miceli, Federica Tomao, Innocenza Palaia, Valentina Zecca, Alessandra Maiuro, Ilaria Balba, Carlo Catalano, Stefania Maria Rita Rizzo, Lucia Manganaro
Format: Article
Language:English
Published: SpringerOpen 2025-05-01
Series:Insights into Imaging
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Online Access:https://doi.org/10.1186/s13244-025-01965-z
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author Marco Gennarini
Rossella Canese
Silvia Capuani
Valentina Miceli
Federica Tomao
Innocenza Palaia
Valentina Zecca
Alessandra Maiuro
Ilaria Balba
Carlo Catalano
Stefania Maria Rita Rizzo
Lucia Manganaro
author_facet Marco Gennarini
Rossella Canese
Silvia Capuani
Valentina Miceli
Federica Tomao
Innocenza Palaia
Valentina Zecca
Alessandra Maiuro
Ilaria Balba
Carlo Catalano
Stefania Maria Rita Rizzo
Lucia Manganaro
author_sort Marco Gennarini
collection DOAJ
description Abstract Purpose This review aims to summarize the current applications of quantitative MRI biomarkers in the staging, treatment response evaluation, and prognostication of endometrial (EC) and cervical cancer (CC). By focusing on functional imaging techniques, we explore how these biomarkers enhance personalized cancer management beyond traditional morphological assessments. Methods A structured search of the PubMed database from January to May 2024 was conducted to identify relevant studies on quantitative MRI in uterine cancers. We included studies examining MRI biomarkers like Dynamic Contrast-Enhanced MRI (DCE-MRI), Diffusion-Weighted Imaging (DWI), and Magnetic Resonance Spectroscopy (MRS), emphasizing their roles in assessing tumor physiology, microstructure, and metabolic changes. Results DCE-MRI provides valuable quantitative biomarkers such as Ktrans and Ve, which reflect microvascular characteristics and tumor aggressiveness, outperforming T2-weighted imaging in detecting critical factors like myometrial and cervical invasion. DWI, including advanced models like Intravoxel Incoherent Motion (IVIM), distinguishes between normal and cancerous tissue and correlates with tumor grade and treatment response. MRS identifies metabolic alterations, such as elevated choline and lipid signals, which serve as prognostic markers in uterine cancers. Conclusion Quantitative MRI offers a noninvasive method to assess key biomarkers that inform prognosis and guide treatment decisions in uterine cancers. By providing insights into tumor biology, these imaging techniques represent a significant step forward in the precision medicine era, allowing for a more tailored therapeutic approach based on the unique pathological and molecular characteristics of each tumor. Critical relevance statement Biomarkers obtained from MRI can provide useful quantitative information about the nature of uterine cancers and their prognosis, both at diagnosis and response assessment, allowing better therapeutic strategies to be prepared. Key Points Quantitative MRI improves diagnosis and management of uterine cancers through advanced imaging biomarkers. Quantitative MRI biomarkers enhance staging, prognosis, and treatment response assessment in uterine cancers. Quantitative MRI biomarkers support personalized treatment strategies and improve patient management in uterine cancers. Graphical Abstract
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spelling doaj-art-56125cb8d7fa43fc8b29c753abc5c9f72025-08-20T03:22:07ZengSpringerOpenInsights into Imaging1869-41012025-05-0116111910.1186/s13244-025-01965-zMulti-model quantitative MRI of uterine cancers in precision medicine’s era—a narrative reviewMarco Gennarini0Rossella Canese1Silvia Capuani2Valentina Miceli3Federica Tomao4Innocenza Palaia5Valentina Zecca6Alessandra Maiuro7Ilaria Balba8Carlo Catalano9Stefania Maria Rita Rizzo10Lucia Manganaro11Department of Radiological, Oncological and Pathological Sciences, Umberto I Hospital, “Sapienza” University of RomeCore Facilities, Istituto Superiore di Sanità, Viale Regina Elena 299National Research Council (CNR), Institute for Complex Systems (ISC) c/o Physics Department Sapienza University of RomeDepartment of Radiological, Oncological and Pathological Sciences, Umberto I Hospital, “Sapienza” University of RomeDepartment of Maternal and Child Health and Urological Sciences, Sapienza University of RomeDepartment of Maternal and Child Health and Urological Sciences, Sapienza University of RomeCore Facilities, Istituto Superiore di Sanità, Viale Regina Elena 299National Research Council (CNR), Institute for Complex Systems (ISC) c/o Physics Department Sapienza University of RomeSiemens Healthcare S.r.l., dAREDepartment of Radiological, Oncological and Pathological Sciences, Umberto I Hospital, “Sapienza” University of RomeIstituto di Imaging della Svizzera Italiana (IIMSI), Ente Ospedaliero Cantonale (EOC)Department of Radiological, Oncological and Pathological Sciences, Umberto I Hospital, “Sapienza” University of RomeAbstract Purpose This review aims to summarize the current applications of quantitative MRI biomarkers in the staging, treatment response evaluation, and prognostication of endometrial (EC) and cervical cancer (CC). By focusing on functional imaging techniques, we explore how these biomarkers enhance personalized cancer management beyond traditional morphological assessments. Methods A structured search of the PubMed database from January to May 2024 was conducted to identify relevant studies on quantitative MRI in uterine cancers. We included studies examining MRI biomarkers like Dynamic Contrast-Enhanced MRI (DCE-MRI), Diffusion-Weighted Imaging (DWI), and Magnetic Resonance Spectroscopy (MRS), emphasizing their roles in assessing tumor physiology, microstructure, and metabolic changes. Results DCE-MRI provides valuable quantitative biomarkers such as Ktrans and Ve, which reflect microvascular characteristics and tumor aggressiveness, outperforming T2-weighted imaging in detecting critical factors like myometrial and cervical invasion. DWI, including advanced models like Intravoxel Incoherent Motion (IVIM), distinguishes between normal and cancerous tissue and correlates with tumor grade and treatment response. MRS identifies metabolic alterations, such as elevated choline and lipid signals, which serve as prognostic markers in uterine cancers. Conclusion Quantitative MRI offers a noninvasive method to assess key biomarkers that inform prognosis and guide treatment decisions in uterine cancers. By providing insights into tumor biology, these imaging techniques represent a significant step forward in the precision medicine era, allowing for a more tailored therapeutic approach based on the unique pathological and molecular characteristics of each tumor. Critical relevance statement Biomarkers obtained from MRI can provide useful quantitative information about the nature of uterine cancers and their prognosis, both at diagnosis and response assessment, allowing better therapeutic strategies to be prepared. Key Points Quantitative MRI improves diagnosis and management of uterine cancers through advanced imaging biomarkers. Quantitative MRI biomarkers enhance staging, prognosis, and treatment response assessment in uterine cancers. Quantitative MRI biomarkers support personalized treatment strategies and improve patient management in uterine cancers. Graphical Abstracthttps://doi.org/10.1186/s13244-025-01965-zMagnetic resonance imagingUterine neoplasmsContrast mediaDiffusion magnetic resonance imagingSpectrum analysis
spellingShingle Marco Gennarini
Rossella Canese
Silvia Capuani
Valentina Miceli
Federica Tomao
Innocenza Palaia
Valentina Zecca
Alessandra Maiuro
Ilaria Balba
Carlo Catalano
Stefania Maria Rita Rizzo
Lucia Manganaro
Multi-model quantitative MRI of uterine cancers in precision medicine’s era—a narrative review
Insights into Imaging
Magnetic resonance imaging
Uterine neoplasms
Contrast media
Diffusion magnetic resonance imaging
Spectrum analysis
title Multi-model quantitative MRI of uterine cancers in precision medicine’s era—a narrative review
title_full Multi-model quantitative MRI of uterine cancers in precision medicine’s era—a narrative review
title_fullStr Multi-model quantitative MRI of uterine cancers in precision medicine’s era—a narrative review
title_full_unstemmed Multi-model quantitative MRI of uterine cancers in precision medicine’s era—a narrative review
title_short Multi-model quantitative MRI of uterine cancers in precision medicine’s era—a narrative review
title_sort multi model quantitative mri of uterine cancers in precision medicine s era a narrative review
topic Magnetic resonance imaging
Uterine neoplasms
Contrast media
Diffusion magnetic resonance imaging
Spectrum analysis
url https://doi.org/10.1186/s13244-025-01965-z
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