Molecular imaging in the management of gynecologic malignancies

Objectives

The purpose of this review is to summarize literature pertaining to clinical roles of positron emission tomography (PET) or integrated PET and computed tomography (PET/CT) scans, magnetic resonance imaging (MRI) and emerging techniques of these two molecular imaging tools for gynecologic malignancies.

Methods

PubMed and MEDLINE databases search for articles published before June 2014 was performed. Only English-language articles were considered. Search terms included “cervical cancer”, “endometrial cancer”, “uterine cancer”, “uterine sarcoma”, “ovarian cancer” and “vulvar cancer”, in association with “FDG”, “PET”, “PET/CT”, “MRI”, “PET/MR”, “diffusion”, “spectroscopy” and “clinical trial”.

Results

Topics explored included PET, PET/CT and MRI for diagnosis of malignancy, prognostic implications, clinical staging of disease extent, monitoring treatment response, post-therapy surveillance, diagnosis of treatment failure and restaging, and follow-up after salvage therapy in gynecologic malignancies.

Conclusions

Molecular imaging (mainly PET and MRI) plays important roles in the management of gynecologic malignancies. Molecular imaging has various impacts in different clinical scenarios. Emerging technologies will continuously improve our practice. Prospective studies with defined endpoints are necessary to evaluate roles of these novel tools in management of gynecologic malignancies.