Table 1

Summary of studies reporting imaging parameters indicating patients eligible for fertility preservation

Author, yearPathologyStudy designImagingParticipantsSelected parameters for FS
Peppercorn PD22 1999Cervical cancerProspective studyMRI30Tumorous distance from the internal os (sensitivity 100% and specificity 96%)
Rob L et al8 2010Cervical cancerNarrative reviewMRINATumor size <2 cm; cervical stroma infiltration (<50%)
Lakhman Y et al12 2012Cervical cancerRetrospective studyMRI62Tumor size <2 cm, absence of deep cervical stromal invasion, tumorous distance from the internal os >5 mm
De Boera P et al10 2013Cervical cancerSystematic reviewMRI366Internal os involvement (sensitivity 91%, specificity 97%)
Noël P et al14 2014Cervical cancerDescriptive studyMRINATumor size < 2 cm; stromal invasion <50% or 1 cm; tumorous distance from the internal os >1 cm; no lymph nodes; no extension beyond the cervix; cervix length >2 cm
Downey K et al 23 2014Cervical cancerProspective studyMRI (endovaginal)55Tumor size; tumorous distance from the internal os
Joumelle C11 2016Cervical cancerRetrospective studyMRI21Tumor size <2 cm (visible in 100% of Stage 1B1 patients, in 60% of Stage 1A2 patients), to be strictly intracervical, no parametrium invasion
Bhosalea PR et al13 2016Cervical cancerRetrospective studyMRI79Tumorous distance from the internal os (specificity 93.8%); assessment of >5 mm distance from the IO (specificity of 98.3%)
Suh DS et al29 2009Endometrial cancerRetrospective studyMRI301Myometrial invasion absent (sensitivity 68.8%, specificity 74.4%, PPV 86.9%, NPV 49.2%)
Cade TJ et al28 2010Endometrial cancerRetrospective studyMRI111Myometrial invasion absent (PPV for all grades 87% and 95% for grade, NPV 35% for all grades and 46% for grade 1)
Rodolakis A et al9 2014Endometrial cancerNarrative reviewMRI and ultrasoundNAMyometrial invasion absent; no synchronous or metastatic ovarian tumors
Sakane M et al30 2017Endometrial cancerProspective studyMRI26Myometrial invasion absent (sensitivity 42%, specificity 85%, PPV 79%, NPV 47%)
Franchi D et al39 2016Borderline ovarian recurrenceProspective studyUltrasound34Growth rate of borderline recurrence ranges from a minimum of 0.06 mm/months for cysts<10 mm up to 1.92 mm/months for cysts>20 mm
Jones BP et al40 2017Borderline ovarian recurrenceProspective studyIntraoperative ultrasound7Intraoperative US to facilitate complete tumor excision in recurrent sBOT minimizing the removal of ovarian tissue
Fischerova D4 2011Cervical cancer, ovarian cancerNarrative reviewUltrasoundNACervical cancer: tumorous distance from the internal os >1 cm. Ovarian tumors: no tumor capsula invasion, controlateral ovary normal.
Rockall AG et al7 2016Cervical cancer, endometrial cancer, ovarian cancerDescriptive studyMRI, ultrasoundNACervical cancer: tumor size <2 cm (or <2.5 cm if the lesion is exophytic); tumorous distance from the internal os >1 cm; no parametrium invasion; no nodal enlargement; no pelvic metastases. Ovarian cancer: no indication for FS-only characterization of adnexal masses. Endometrial cancer: no cervical and myometrial invasion
McEvoy et al5 2017Cervical cancer, endometrial cancer, ovarian cancerNarrative reviewMRINACervical cancer: tumor size ≤2 cm for fertility preservation (some centers accept tumor size ≤4 cm, particularly if exophytic); tumor-to-internal os distance ≥1 cm (some centers accept ≥0.5 cm); cervical stromal invasion (CSI)<50% (some centers accept: any degree of CSI); absence of parametrial invasion; absence of lymph node metastases. Endometrial cancer: disease confined to the endometrium; absence of any myometrial invasion; absence of cervical stromal invasion; absence of synchronous primary ovarian cancer or ovarian metastases; absence of lymph node metastases. Ovarian tumors: no indication for FS-only to discriminate between benign and malignant tumors
Stein EB6 2019Cervical cancer, endometrial cancer, ovarian cancerDescriptive studyMRINACervical cancer: tumor size <2 cm; tumorous distance from the internal os >1 cm; cervical stromal invasion <50%; nodal or distant metastatic disease absent. Endometrial cancer: no myometrial and cervical invasion; no extrauterine disease. Ovarian cancer: no indication for FS-only characterization of adnexal masses; absence of extraovarian disease