Role of MR imaging and FDG PET/ CT in selection and follow-up of patients treated with pelvic exenteration for gynecologic malignancies Journal Article


Authors: Lakhman, Y.; Nougaret, S.; Miccò, M; Scelzo, C.; Vargas, H. A.; Sosa, R. E.; Sutton, E. J.; Chi, D. S.; Hricak, H.; Sala, E.
Article Title: Role of MR imaging and FDG PET/ CT in selection and follow-up of patients treated with pelvic exenteration for gynecologic malignancies
Abstract: Pelvic exenteration (PE) is a radical surgical procedure used for the past 6 decades to treat locally advanced malignant diseases confined to the pelvis, particularly persistent or recurrent gynecologic cancers in the irradiated pelvis. The traditional surgical technique known as total PE consists of resection of all pelvic viscera followed by reconstruction. Depending on the tumor extent, the procedure can be tailored to remove only anterior or posterior structures, including the bladder (anterior exenteration) or rectum (posterior exenteration). Conversely, more extended pelvic resection can be performed if the pelvic sidewall is invaded by cancer. Preoperative imaging evaluation with magnetic resonance (MR) imaging and fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is central to establishing tumor resectability and therefore patient eligibility for the procedure. These imaging modalities complement each other in diagnosis of tumor recurrence and differentiation of persistent disease from posttreatment changes. MR imaging can accurately demonstrate local tumor extent and show adjacent organ invasion. FDG PET/ CT is useful in excluding nodal and distant metastases. In addition, FDG PET/CT metrics may serve as predictive biomarkers for over- all and disease-free survival. This pictorial review describes different types of exenterative surgical procedures and illustrates the central role of imaging in accurate patient selection, treatment planning, and postsurgical surveillance. © RSNA, 2015 • radiographics.rsna.org.
Journal Title: RadioGraphics
Volume: 35
Issue: 4
ISSN: 0271-5333
Publisher: Radiological Society of North America, Inc.  
Date Published: 2015-07-01
Start Page: 1295
End Page: 1313
Language: English
DOI: 10.1148/rg.2015140313
PROVIDER: scopus
PUBMED: 26172364
PMCID: PMC4959795
DOI/URL:
Notes: Export Date: 2 September 2015 -- Source: Scopus
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MSK Authors
  1. Yuliya Lakhman
    34 Lakhman
  2. Evis Sala
    95 Sala
  3. Dennis S Chi
    496 Chi
  4. Hedvig Hricak
    333 Hricak
  5. Elizabeth Jane Sutton
    26 Sutton
  6. Ramon Elias Sosa
    16 Sosa