Role of Imaging in Fertility-sparing Treatment of Gynecologic Malignancies

Treatments for gynecologic cancer usually result in loss of fertility due to surgery or radical radiation therapy in the pelvis. In countries with an established screening program for cervical cancer, the majority of gynecologic malignancies occur in postmenopausal women. However, a substantial numb...

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Veröffentlicht in:Radiographics 2016-11, Vol.36 (7), p.2214-2233
Hauptverfasser: Rockall, Andrea G, Qureshi, Mahrukh, Papadopoulou, Ioanna, Saso, Srdjan, Butterfield, Nicholas, Thomassin-Naggara, Isabelle, Farthing, Alan, Smith, J Richard, Bharwani, Nishat
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container_end_page 2233
container_issue 7
container_start_page 2214
container_title Radiographics
container_volume 36
creator Rockall, Andrea G
Qureshi, Mahrukh
Papadopoulou, Ioanna
Saso, Srdjan
Butterfield, Nicholas
Thomassin-Naggara, Isabelle
Farthing, Alan
Smith, J Richard
Bharwani, Nishat
description Treatments for gynecologic cancer usually result in loss of fertility due to surgery or radical radiation therapy in the pelvis. In countries with an established screening program for cervical cancer, the majority of gynecologic malignancies occur in postmenopausal women. However, a substantial number of affected women are of childbearing age and have not completed their families. In these younger women, consideration of fertility preservation may be important. This article describes the fertility-sparing treatment options that are currently available and outlines the role of imaging in the selection of eligible patients on the basis of a review of the literature. In the setting of cervical cancer, magnetic resonance (MR) imaging is used to delineate the size, position, and stage of the tumor for selection of patients who are suitable for radical trachelectomy. In patients with solitary complex adnexal masses, diffusion- and perfusion-weighted MR imaging sequences are used to categorize the likelihood of invasive or borderline malignancy for consideration of unilateral ovarian resection, with fertility preservation when possible. In patients with endometrial cancer, MR imaging is used to rule out signs of invasive disease before hormone therapy is considered. Imaging is also used at patient follow-up to detect recurrent disease; however, evidence to support this application is limited. In conclusion, imaging is an essential tool in the care of patients with gynecologic malignancies who are considering fertility-preserving treatment options. RSNA, 2016.
doi_str_mv 10.1148/rg.2016150254
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In patients with solitary complex adnexal masses, diffusion- and perfusion-weighted MR imaging sequences are used to categorize the likelihood of invasive or borderline malignancy for consideration of unilateral ovarian resection, with fertility preservation when possible. In patients with endometrial cancer, MR imaging is used to rule out signs of invasive disease before hormone therapy is considered. Imaging is also used at patient follow-up to detect recurrent disease; however, evidence to support this application is limited. In conclusion, imaging is an essential tool in the care of patients with gynecologic malignancies who are considering fertility-preserving treatment options. 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In patients with solitary complex adnexal masses, diffusion- and perfusion-weighted MR imaging sequences are used to categorize the likelihood of invasive or borderline malignancy for consideration of unilateral ovarian resection, with fertility preservation when possible. In patients with endometrial cancer, MR imaging is used to rule out signs of invasive disease before hormone therapy is considered. Imaging is also used at patient follow-up to detect recurrent disease; however, evidence to support this application is limited. In conclusion, imaging is an essential tool in the care of patients with gynecologic malignancies who are considering fertility-preserving treatment options. 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subjects Female
Fertility Preservation - methods
Genital Neoplasms, Female - diagnostic imaging
Genital Neoplasms, Female - pathology
Genital Neoplasms, Female - surgery
Gynecologic Surgical Procedures - methods
Humans
Magnetic Resonance Imaging - methods
Neoplasm Staging
Organ Sparing Treatments - methods
Preoperative Care - methods
Surgery, Computer-Assisted - methods
title Role of Imaging in Fertility-sparing Treatment of Gynecologic Malignancies
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