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Magnetic resonance imaging in gynaecological malignancies

Academic Department of Radiology, St Bartholomew's Hospital, Barts and the London NHS Trust, Dominion House, West Smithfield, London, EC1A 7BE, UK. email: anju{at}panda-tech.com (corresponding author)

John H Shepherd, FRCS FRCOG, Professor of Obstetrics and Gynaecology

Department of Oncological Gynaecology, St Bartholomew's Hospital, London, UK.

Rodney H Reznek, FRCP FRCR, Professor of Diagnostic Radiology

Academic Department of Radiology, St Bartholomew's Hospital, London, UK.

In this article the current and developing roles of magnetic resonance imaging (MRI) in endometrial, cervical and ovarian cancer are reviewed. In endometrial cancer, MRI is used to identify myometrial invasion and extrauterine disease, allowing preoperative surgical planning in women with serious comorbidity. In cervical cancer, MRI has an established role in local staging. By assessing the proximal extension of tumours in young women, MRI determines the feasibility of fertility-preserving surgery. It is also used to plan and administer radiotherapy. This optimises tumour radiation, while limiting unwanted radiation to the bowel and other pelvic organs. In ovarian cancer, MRI is useful in young women as it is superior to ultrasound in diagnosing endometriomas, dermoids and fibroids, which can be misdiagnosed by ultrasound as malignant lesions.

Keywords Keywords / cervical cancer / endometrial cancer / gynaecological malignancy / magnetic resonance imaging / ovarian cancer