Female Pelvis



High-quality diagnostics of female pelvic malignancies is of particular importance for the selection of an appropriate treatment strategy as well as to predict prognosis.

In this context, advanced imaging techniques have gained an increasing role within the last decades for therapy planning and disease monitoring. In particular, magnetic resonance imaging (MRI) and positron emission tomography (PET) represent two important imaging techniques, which are frequently applied for primary tumor evaluation as well as the identification of potential tumor relapse. Furthermore, these imaging modalities enable the acquisition of certain functional and metabolic quantitative datasets, representing different aspects of underlying tumor biology, which facilitates a more comprehensive assessment of specific organs and pathologies. Accordingly, this chapter describes the diagnostic benefits and potential clinical application fields of integrated PET/MRI for the evaluation of gynecological cancers.


  1. Aerts HJ, Velazquez ER, Leijenaar RT, Parmar C, Grossmann P, Carvalho S, et al. Decoding tumour phenotype by noninvasive imaging using a quantitative radiomics approach. Nat Commun. 2014;5:4006.PubMedPubMedCentralGoogle Scholar
  2. Antoch G, Stattaus J, Nemat AT, Marnitz S, Beyer T, Kuehl H, et al. Non-small cell lung cancer: dual-modality PET/CT in preoperative staging. Radiology. 2003;229(2):526–33.PubMedCrossRefGoogle Scholar
  3. Antoch G, Vogt FM, Freudenberg LS, Nazaradeh F, Goehde SC, Barkhausen J, et al. Whole-body dual-modality PET/CT and whole-body MRI for tumor staging in oncology. JAMA. 2003;290(24):3199–206.PubMedCrossRefGoogle Scholar
  4. Bar-Shalom R, Yefremov N, Guralnik L, Gaitini D, Frenkel A, Kuten A, et al. Clinical performance of PET/CT in evaluation of cancer: additional value for diagnostic imaging and patient management. J Nucl Med. 2003;44(8):1200–9.PubMedGoogle Scholar
  5. Beddy P, O'Neill AC, Yamamoto AK, Addley HC, Reinhold C, Sala E. FIGO staging system for endometrial cancer: added benefits of MR imaging. Radiographics. 2012;32(1):241–54.PubMedCrossRefGoogle Scholar
  6. Beiderwellen K, Geraldo L, Ruhlmann V, Heusch P, Gomez B, Nensa F, et al. Accuracy of [18F]FDG PET/MRI for the detection of liver metastases. PLoS One. 2015;10(9):e0137285.PubMedPubMedCentralCrossRefGoogle Scholar
  7. Beiderwellen K, Gomez B, Buchbender C, Hartung V, Poeppel TD, Nensa F, et al. Depiction and characterization of liver lesions in whole body [(1)(8)F]-FDG PET/MRI. Eur J Radiol. 2013;82(11):e669–75.PubMedCrossRefGoogle Scholar
  8. Beiderwellen K, Grueneisen J, Ruhlmann V, Buderath P, Aktas B, Heusch P, et al. [(18)F]FDG PET/MRI vs. PET/CT for whole-body staging in patients with recurrent malignancies of the female pelvis: initial results. Eur J Nucl Med Mol Imaging. 2015;42(1):56–65.PubMedCrossRefGoogle Scholar
  9. Beiderwellen K, Huebner M, Heusch P, Grueneisen J, Ruhlmann V, Nensa F, et al. Whole-body [(1)(8)F]FDG PET/MRI vs. PET/CT in the assessment of bone lesions in oncological patients: initial results. Eur Radiol. 2014;24(8):2023–30.PubMedCrossRefGoogle Scholar
  10. Belhocine T, De Barsy C, Hustinx R, Willems-Foidart J. Usefulness of (18)F-FDG PET in the post-therapy surveillance of endometrial carcinoma. Eur J Nucl Med Mol Imaging. 2002;29(9):1132–9.PubMedCrossRefGoogle Scholar
  11. Bellone S, Pecorelli S, Cannon MJ, Santin AD. Advances in dendritic-cell-based therapeutic vaccines for cervical cancer. Expert Rev Anticancer Ther. 2007;7(10):1473–86.PubMedCrossRefGoogle Scholar
  12. Berman ML, Ballon SC, Lagasse LD, Watring WG. Prognosis and treatment of endometrial cancer. Am J Obstet Gynecol. 1980;136(5):679–88.PubMedCrossRefGoogle Scholar
  13. Bipat S, Glas AS, van der Velden J, Zwinderman AH, Bossuyt PM, Stoker J. Computed tomography and magnetic resonance imaging in staging of uterine cervical carcinoma: a systematic review. Gynecol Oncol. 2003;91(1):59–66.PubMedCrossRefGoogle Scholar
  14. Bjurberg M, Brun E. Clinical impact of 2-deoxy-2-[18F]fluoro-D-glucose (FDG)-positron emission tomography (PET) on treatment choice in recurrent cancer of the cervix uteri. Int J Gynecol Cancer. 2013;23(9):1642–6.PubMedCrossRefGoogle Scholar
  15. Bollineni VR, Ytre-Hauge S, Bollineni-Balabay O, Salvesen HB, Haldorsen IS. High diagnostic value of 18F-FDG PET/CT in endometrial cancer: systematic review and meta-analysis of the literature. J Nucl Med. 2016;57(6):879–85.PubMedCrossRefGoogle Scholar
  16. Brandmaier P, Purz S, Bremicker K, Hockel M, Barthel H, Kluge R, et al. Simultaneous [18F]FDG-PET/MRI: correlation of Apparent Diffusion Coefficient (ADC) and Standardized Uptake Value (SUV) in primary and recurrent cervical cancer. PLoS One. 2015;10(11):e0141684.PubMedPubMedCentralCrossRefGoogle Scholar
  17. Buchbender C, Hartung-Knemeyer V, Beiderwellen K, Heusch P, Kuhl H, Lauenstein TC, et al. Diffusion-weighted imaging as part of hybrid PET/MRI protocols for whole-body cancer staging: does it benefit lesion detection? Eur J Radiol. 2013;82(5):877–82.PubMedCrossRefGoogle Scholar
  18. Cavaliere C, Romeo V, Aiello M, Mesolella M, Iorio B, Barbuto L, et al. Multiparametric evaluation by simultaneous PET-MRI examination in patients with histologically proven laryngeal cancer. Eur J Radiol. 2017;88:47–55.PubMedCrossRefGoogle Scholar
  19. Choi HJ, Ju W, Myung SK, Kim Y. Diagnostic performance of computer tomography, magnetic resonance imaging, and positron emission tomography or positron emission tomography/computer tomography for detection of metastatic lymph nodes in patients with cervical cancer: meta-analysis. Cancer Sci. 2010;101(6):1471–9.PubMedCrossRefGoogle Scholar
  20. Choi HJ, Roh JW, Seo SS, Lee S, Kim JY, Kim SK, et al. Comparison of the accuracy of magnetic resonance imaging and positron emission tomography/computed tomography in the presurgical detection of lymph node metastases in patients with uterine cervical carcinoma: a prospective study. Cancer. 2006;106(4):914–22.PubMedCrossRefGoogle Scholar
  21. Coroller TP, Grossmann P, Hou Y, Rios Velazquez E, Leijenaar RT, Hermann G, et al. CT-based radiomic signature predicts distant metastasis in lung adenocarcinoma. Radiother Oncol. 2015;114(3):345–50.PubMedPubMedCentralCrossRefGoogle Scholar
  22. Creutzberg CL, van Putten WL, Koper PC, Lybeert ML, Jobsen JJ, Warlam-Rodenhuis CC, et al. Surgery and postoperative radiotherapy versus surgery alone for patients with stage-1 endometrial carcinoma: multicentre randomised trial. PORTEC Study Group Post Operative Radiation Therapy in Endometrial Carcinoma. Lancet. 2000;355(9213):1404–11.PubMedCrossRefGoogle Scholar
  23. Delgado G, Bundy B, Zaino R, Sevin BU, Creasman WT, Major F. Prospective surgical-pathological study of disease-free interval in patients with stage IB squamous cell carcinoma of the cervix: a Gynecologic Oncology Group study. Gynecol Oncol. 1990;38(3):352–7.PubMedCrossRefGoogle Scholar
  24. Delso G, Furst S, Jakoby B, Ladebeck R, Ganter C, Nekolla SG, et al. Performance measurements of the Siemens mMR integrated whole-body PET/MR scanner. J Nucl Med. 2011;52(12):1914–22.PubMedCrossRefGoogle Scholar
  25. Deuschl C, Moenninghoff C, Goericke S, Kirchner J, Koppen S, Binse I, et al. Response assessment of bevacizumab therapy in GBM with integrated 11C-MET-PET/MRI: a feasibility study. Eur J Nucl Med Mol Imaging. 2017;Google Scholar
  26. Eiber M, Takei T, Souvatzoglou M, Mayerhoefer ME, Furst S, Gaertner FC, et al. Performance of whole-body integrated 18F-FDG PET/MR in comparison to PET/CT for evaluation of malignant bone lesions. J Nucl Med. 2014;55(2):191–7.PubMedCrossRefGoogle Scholar
  27. Fuller AF, Jr., Elliott N, Kosloff C, Hoskins WJ, Lewis JL, Jr. Determinants of increased risk for recurrence in patients undergoing radical hysterectomy for stage IB and IIA carcinoma of the cervix. Gynecol Oncol 1989;33(1):34-39.Google Scholar
  28. Erfanian Y, Grueneisen J, Kirchner J, Wetter A, Podleska LE, Bauer S, et al. Integrated 18F-FDG PET/MRI compared to MRI alone for identification of local recurrences of soft tissue sarcomas: a comparison trial. Eur J Nucl Med Mol Imaging. 2017;Google Scholar
  29. Fiaschetti V, Calabria F, Crusco S, Meschini A, Nucera F, Schillaci O, et al. MR-PET fusion imaging in evaluating adnexal lesions: a preliminary study. Radiol Med. 2011;116(8):1288–302.PubMedCrossRefGoogle Scholar
  30. Forstner R, Hricak H, Occhipinti KA, Powell CB, Frankel SD, Stern JL. Ovarian cancer: staging with CT and MR imaging. Radiology. 1995;197(3):619–26.PubMedCrossRefGoogle Scholar
  31. Forstner R, Sala E, Kinkel K, Spencer JA. European Society of Urogenital R. ESUR guidelines: ovarian cancer staging and follow-up. Eur Radiol. 2010;20(12):2773–80.PubMedCrossRefGoogle Scholar
  32. Freeman SJ, Aly AM, Kataoka MY, Addley HC, Reinhold C, Sala E. The revised FIGO staging system for uterine malignancies: implications for MR imaging. Radiographics. 2012;32(6):1805–27.PubMedCrossRefGoogle Scholar
  33. Friedlander M, Grogan M, Force USPST. Guidelines for the treatment of recurrent and metastatic cervical cancer. Oncologist. 2002;7(4):342–7.PubMedGoogle Scholar
  34. Fujii S, Matsusue E, Kanasaki Y, Kanamori Y, Nakanishi J, Sugihara S, et al. Detection of peritoneal dissemination in gynecological malignancy: evaluation by diffusion-weighted MR imaging. Eur Radiol. 2008;18(1):18–23.PubMedCrossRefGoogle Scholar
  35. Fulcher AS, O'Sullivan SG, Segreti EM, Kavanagh BD. Recurrent cervical carcinoma: typical and atypical manifestations. Radiographics. 1999;19. Spec No:S103-16; quiz S264-5Google Scholar
  36. Gillies RJ, Kinahan PE, Hricak H. Radiomics: images are more than pictures, they are data. Radiology. 2016;278(2):563–77.PubMedCrossRefGoogle Scholar
  37. Grant P, Sakellis C, Jacene HA. Gynecologic oncologic imaging with PET/CT. Semin Nucl Med. 2014;44(6):461–78.PubMedCrossRefGoogle Scholar
  38. Grueneisen J, Beiderwellen K, Heusch P, Buderath P, Aktas B, Gratz M, et al. Correlation of standardized uptake value and apparent diffusion coefficient in integrated whole-body PET/MRI of primary and recurrent cervical cancer. PLoS One. 2014;9(5):e96751.PubMedPubMedCentralCrossRefGoogle Scholar
  39. Grueneisen J, Beiderwellen K, Heusch P, Gratz M, Schulze-Hagen A, Heubner M, et al. Simultaneous positron emission tomography/magnetic resonance imaging for whole-body staging in patients with recurrent gynecological malignancies of the pelvis: a comparison to whole-body magnetic resonance imaging alone. Investig Radiol. 2014;49(12):808–15.CrossRefGoogle Scholar
  40. Grueneisen J, Sawicki LM, Schaarschmidt BM, Suntharalingam S, von der Ropp S, Wetter A, et al. Evaluation of a fast protocol for staging lymphoma patients with integrated PET/MRI. PLoS One. 2016;11(6):e0157880.PubMedPubMedCentralCrossRefGoogle Scholar
  41. Grueneisen J, Sawicki LM, Wetter A, Kirchner J, Kinner S, Aktas B, et al. Evaluation of PET and MR datasets in integrated 18F-FDG PET/MRI: a comparison of different MR sequences for whole-body restaging of breast cancer patients. Eur J Radiol. 2017;89:14–9.PubMedCrossRefGoogle Scholar
  42. Grueneisen J, Schaarschmidt BM, Beiderwellen K, Schulze-Hagen A, Heubner M, Kinner S, et al. Diagnostic value of diffusion-weighted imaging in simultaneous 18F-FDG PET/MR imaging for whole-body staging of women with pelvic malignancies. J Nucl Med. 2014;55(12):1930–5.PubMedCrossRefGoogle Scholar
  43. Grueneisen J, Schaarschmidt BM, Heubner M, Aktas B, Kinner S, Forsting M, et al. Integrated PET/MRI for whole-body staging of patients with primary cervical cancer: preliminary results. Eur J Nucl Med Mol Imaging. 2015;42(12):1814–24.PubMedCrossRefGoogle Scholar
  44. Grueneisen J, Schaarschmidt BM, Heubner M, Suntharalingam S, Milk I, Kinner S, et al. Implementation of FAST-PET/MRI for whole-body staging of female patients with recurrent pelvic malignancies: a comparison to PET/CT. Eur J Radiol. 2015;84(11):2097–102.PubMedCrossRefGoogle Scholar
  45. Gu J, Chan T, Zhang J, Leung AY, Kwong YL, Khong PL. Whole-body diffusion-weighted imaging: the added value to whole-body MRI at initial diagnosis of lymphoma. AJR Am J Roentgenol. 2011;197(3):W384–91.PubMedCrossRefGoogle Scholar
  46. Gu P, Pan LL, Wu SQ, Sun L, Huang G. CA 125, PET alone, PET-CT, CT and MRI in diagnosing recurrent ovarian carcinoma: a systematic review and meta-analysis. Eur J Radiol. 2009;71(1):164–74.PubMedCrossRefGoogle Scholar
  47. Hartung-Knemeyer V, Beiderwellen KJ, Buchbender C, Kuehl H, Lauenstein TC, Bockisch A, et al. Optimizing positron emission tomography image acquisition protocols in integrated positron emission tomography/magnetic resonance imaging. Investig Radiol. 2013;48(5):290–4.CrossRefGoogle Scholar
  48. Hoh CK, Hawkins RA, Glaspy JA, Dahlbom M, Tse NY, Hoffman EJ, et al. Cancer detection with whole-body PET using 2-[18F]fluoro-2-deoxy-D-glucose. J Comput Assist Tomogr. 1993;17(4):582–9.PubMedCrossRefGoogle Scholar
  49. Hricak H, Chen M, Coakley FV, Kinkel K, KK Y, Sica G, et al. Complex adnexal masses: detection and characterization with MR imaging – multivariate analysis. Radiology. 2000;214(1):39–46.PubMedCrossRefGoogle Scholar
  50. Huynh E, Coroller TP, Narayan V, Agrawal V, Hou Y, Romano J, et al. CT-based radiomic analysis of stereotactic body radiation therapy patients with lung cancer. Radiother Oncol. 2016;120(2):258–66.PubMedCrossRefGoogle Scholar
  51. Johnson W, Taylor MB, Carrington BM, Bonington SC, Swindell R. The value of hyoscine butylbromide in pelvic MRI. Clin Radiol. 2007;62(11):1087–93.PubMedCrossRefGoogle Scholar
  52. Kadkhodayan S, Shahriari S, Treglia G, Yousefi Z, Sadeghi R. Accuracy of 18-F-FDG PET imaging in the follow up of endometrial cancer patients: systematic review and meta-analysis of the literature. Gynecol Oncol. 2013;128(2):397–404.PubMedCrossRefGoogle Scholar
  53. Kavanagh BD, Gieschen HL, Schmidt-Ullrich RK, Arthur D, Zwicker R, Kaufman N, et al. A pilot study of concomitant boost accelerated superfractionated radiotherapy for stage III cancer of the uterine cervix. Int J Radiat Oncol Biol Phys. 1997;38(3):561–8.PubMedCrossRefGoogle Scholar
  54. Kelly-Morland C, Rudman S, Nathan P, Mallett S, Montana G, Cook G, et al. Evaluation of treatment response and resistance in metastatic renal cell cancer (mRCC) using integrated 18F-Fluorodeoxyglucose (18F-FDG) positron emission tomography/magnetic resonance imaging (PET/MRI); The REMAP study. BMC Cancer. 2017;17(1):392.PubMedPubMedCentralCrossRefGoogle Scholar
  55. Kidd EA, Siegel BA, Dehdashti F, Grigsby PW. Pelvic lymph node F-18 fluorodeoxyglucose uptake as a prognostic biomarker in newly diagnosed patients with locally advanced cervical cancer. Cancer. 2010;116(6):1469–75.PubMedCrossRefGoogle Scholar
  56. Kim HJ, Cho A, Yun M, Kim YT, Kang WJ. Comparison of FDG PET/CT and MRI in lymph node staging of endometrial cancer. Ann Nucl Med. 2016;30(2):104–13.PubMedCrossRefGoogle Scholar
  57. Kim SH, Kim HD, Song YS, Kang SB, Lee HP. Detection of deep myometrial invasion in endometrial carcinoma: comparison of transvaginal ultrasound, CT, and MRI. J Comput Assist Tomogr. 1995;19(5):766–72.PubMedCrossRefGoogle Scholar
  58. Kinkel K, Forstner R, Danza FM, Oleaga L, Cunha TM, Bergman A, et al. Staging of endometrial cancer with MRI: guidelines of the European Society of Urogenital Imaging. Eur Radiol. 2009;19(7):1565–74.PubMedCrossRefGoogle Scholar
  59. Kinkel K, Kaji Y, KK Y, Segal MR, Lu Y, Powell CB, et al. Radiologic staging in patients with endometrial cancer: a meta-analysis. Radiology. 1999;212(3):711–8.PubMedCrossRefGoogle Scholar
  60. Kinkel K, Lu Y, Mehdizade A, Pelte MF, Hricak H. Indeterminate ovarian mass at US: incremental value of second imaging test for characterization – meta-analysis and Bayesian analysis. Radiology. 2005;236(1):85–94.PubMedCrossRefGoogle Scholar
  61. Kirchner J, Deuschl C, Schweiger B, Herrmann K, Forsting M, Buchbender C, et al. Imaging children suffering from lymphoma: an evaluation of different 18F-FDG PET/MRI protocols compared to whole-body DW-MRI. Eur J Nucl Med Mol Imaging. 2017;Google Scholar
  62. Kirchner J, Sawicki LM, Suntharalingam S, Grueneisen J, Ruhlmann V, Aktas B, et al. Whole-body staging of female patients with recurrent pelvic malignancies: Ultra-fast 18F-FDG PET/MRI compared to 18F-FDG PET/CT and CT. PLoS One. 2017;12(2):e0172553.PubMedPubMedCentralCrossRefGoogle Scholar
  63. Kitajima K, Murakami K, Yamasaki E, Domeki Y, Kaji Y, Fukasawa I, et al. Performance of integrated FDG-PET/contrast-enhanced CT in the diagnosis of recurrent ovarian cancer: comparison with integrated FDG-PET/non-contrast-enhanced CT and enhanced CT. Eur J Nucl Med Mol Imaging. 2008;35(8):1439–48.PubMedCrossRefGoogle Scholar
  64. Kitajima K, Murakami K, Yamasaki E, Domeki Y, Kaji Y, Morita S, et al. Performance of integrated FDG-PET/contrast-enhanced CT in the diagnosis of recurrent uterine cancer: comparison with PET and enhanced CT. Eur J Nucl Med Mol Imaging. 2009;36(3):362–72.PubMedCrossRefGoogle Scholar
  65. Kitajima K, Murakami K, Yamasaki E, Kaji Y, Fukasawa I, Inaba N, et al. Diagnostic accuracy of integrated FDG-PET/contrast-enhanced CT in staging ovarian cancer: comparison with enhanced CT. Eur J Nucl Med Mol Imaging. 2008;35(10):1912–20.PubMedCrossRefGoogle Scholar
  66. Kitajima K, Suenaga Y, Ueno Y, Kanda T, Maeda T, Makihara N, et al. Value of fusion of PET and MRI in the detection of intra-pelvic recurrence of gynecological tumor: comparison with 18F-FDG contrast-enhanced PET/CT and pelvic MRI. Ann Nucl Med. 2014;28(1):25–32.PubMedCrossRefGoogle Scholar
  67. Kitajima K, Suenaga Y, Ueno Y, Kanda T, Maeda T, Takahashi S, et al. Value of fusion of PET and MRI for staging of endometrial cancer: comparison with (1)(8)F-FDG contrast-enhanced PET/CT and dynamic contrast-enhanced pelvic MRI. Eur J Radiol. 2013;82(10):1672–6.PubMedCrossRefGoogle Scholar
  68. Koh WJ, Greer BE, Abu-Rustum NR, Apte SM, Campos SM, Chan J, et al. Cervical cancer. J Natl Compr Cancer Netw. 2013;11(3):320–43.CrossRefGoogle Scholar
  69. Kovac JD, Terzic M, Mirkovic M, Banko B, Dikic-Rom A, Maksimovic R. Endometrioid adenocarcinoma of the ovary: MRI findings with emphasis on diffusion-weighted imaging for the differentiation of ovarian tumors. Acta Radiol. 2016;57(6):758–66.PubMedCrossRefGoogle Scholar
  70. Kuang F, Ren J, Zhong Q, Liyuan F, Huan Y, Chen Z. The value of apparent diffusion coefficient in the assessment of cervical cancer. Eur Radiol. 2013;23(4):1050–8.PubMedCrossRefGoogle Scholar
  71. Lagasse LD, Creasman WT, Shingleton HM, Ford JH, Blessing JA. Results and complications of operative staging in cervical cancer: experience of the Gynecologic Oncology Group. Gynecol Oncol. 1980;9(1):90–8.PubMedCrossRefGoogle Scholar
  72. Lambin P, Rios-Velazquez E, Leijenaar R, Carvalho S, van Stiphout RG, Granton P, et al. Radiomics: extracting more information from medical images using advanced feature analysis. Eur J Cancer. 2012;48(4):441–6.PubMedPubMedCentralCrossRefGoogle Scholar
  73. Larson DM, Connor GP, Broste SK, Krawisz BR, Johnson KK. Prognostic significance of gross myometrial invasion with endometrial cancer. Obstet Gynecol. 1996;88(3):394–8.PubMedCrossRefGoogle Scholar
  74. Lartizien C, Comtat C, Kinahan PE, Ferreira N, Bendriem B, Trebossen R. Optimization of injected dose based on noise equivalent count rates for 2- and 3-dimensional whole-body PET. J Nucl Med. 2002;43(9):1268–78.PubMedGoogle Scholar
  75. Lee DH, Kim SH, Im SA, DY O, Kim TY, Han JK. Multiparametric fully-integrated 18-FDG PET/MRI of advanced gastric cancer for prediction of chemotherapy response: a preliminary study. Eur Radiol. 2016;26(8):2771–8.PubMedCrossRefGoogle Scholar
  76. Lee SY, Jee WH, Jung JY, Park MY, Kim SK, Jung CK, et al. Differentiation of malignant from benign soft tissue tumours: use of additive qualitative and quantitative diffusion-weighted MR imaging to standard MR imaging at 3.0 T. Eur Radiol. 2016;26(3):743–54.PubMedCrossRefGoogle Scholar
  77. Liu Y, Liu H, Bai X, Ye Z, Sun H, Bai R, et al. Differentiation of metastatic from non-metastatic lymph nodes in patients with uterine cervical cancer using diffusion-weighted imaging. Gynecol Oncol. 2011;122(1):19–24.PubMedCrossRefGoogle Scholar
  78. Low RN, Sebrechts CP, Barone RM, Muller W. Diffusion-weighted MRI of peritoneal tumors: comparison with conventional MRI and surgical and histopathologic findings – a feasibility study. AJR Am J Roentgenol. 2009;193(2):461–70.PubMedCrossRefGoogle Scholar
  79. Magne N, Chargari C, Vicenzi L, Gillion N, Messai T, Magne J, et al. New trends in the evaluation and treatment of cervix cancer: the role of FDG-PET. Cancer Treat Rev. 2008;34(8):671–81.PubMedCrossRefGoogle Scholar
  80. Mangili G, Picchio M, Sironi S, Vigano R, Rabaiotti E, Bornaghi D, et al. Integrated PET/CT as a first-line re-staging modality in patients with suspected recurrence of ovarian cancer. Eur J Nucl Med Mol Imaging. 2007;34(5):658–66.PubMedCrossRefGoogle Scholar
  81. Menzel C, Dobert N, Hamscho N, Zaplatnikov K, Vasvatekis S, Matic V, et al. The influence of CA 125 and CEA levels on the results of (18)F-deoxyglucose positron emission tomography in suspected recurrence of epithelial ovarian cancer. Strahlenther Onkol. 2004;180(8):497–501.PubMedCrossRefGoogle Scholar
  82. Michielsen K, Vergote I, Op de Beeck K, Amant F, Leunen K, Moerman P, et al. Whole-body MRI with diffusion-weighted sequence for staging of patients with suspected ovarian cancer: a clinical feasibility study in comparison to CT and FDG-PET/CT. Eur Radiol. 2014;24(4):889–901.PubMedCrossRefGoogle Scholar
  83. Mirpour S, Mhlanga JC, Logeswaran P, Russo G, Mercier G, Subramaniam RM. The role of PET/CT in the management of cervical cancer. AJR Am J Roentgenol. 2013;201(2):W192–205.PubMedCrossRefGoogle Scholar
  84. Murakami M, Miyamoto T, Iida T, Tsukada H, Watanabe M, Shida M, et al. Whole-body positron emission tomography and tumor marker CA125 for detection of recurrence in epithelial ovarian cancer. Int J Gynecol Cancer. 2006;16(Suppl 1):99–107.PubMedCrossRefGoogle Scholar
  85. Murakami T, Kurachi H, Nakamura H, Tsuda K, Miyake A, Tomoda K, et al. Cervical invasion of endometrial carcinoma – evaluation by parasagittal MR imaging. Acta Radiol. 1995;36(3):248–53.PubMedCrossRefGoogle Scholar
  86. Nakamura K, Joja I, Kodama J, Hongo A, Hiramatsu Y. Measurement of SUVmax plus ADCmin of the primary tumour is a predictor of prognosis in patients with cervical cancer. Eur J Nucl Med Mol Imaging. 2012;39(2):283–90.PubMedCrossRefGoogle Scholar
  87. Nensa F, Beiderwellen K, Heusch P, Wetter A. Clinical applications of PET/MRI: current status and future perspectives. Diagn Interv Radiol. 2014;20(5):438–47.PubMedPubMedCentralCrossRefGoogle Scholar
  88. Nie J, Zhang J, Gao J, Guo L, Zhou H, Hu Y, et al. Diagnostic role of 18F-FDG PET/MRI in patients with gynecological malignancies of the pelvis: a systematic review and meta-analysis. PLoS One. 2017;12(5):e0175401.PubMedPubMedCentralCrossRefGoogle Scholar
  89. Park JJ, Kim CK, Park SY, Simonetti AW, Kim E, Park BK, et al. Assessment of early response to concurrent chemoradiotherapy in cervical cancer: value of diffusion-weighted and dynamic contrast-enhanced MR imaging. Magn Reson Imaging. 2014;32(8):993–1000.PubMedCrossRefGoogle Scholar
  90. Park JY, Kim EN, Kim DY, Suh DS, Kim JH, Kim YM, et al. Comparison of the validity of magnetic resonance imaging and positron emission tomography/computed tomography in the preoperative evaluation of patients with uterine corpus cancer. Gynecol Oncol. 2008;108(3):486–92.PubMedCrossRefGoogle Scholar
  91. Pecorelli S, Zigliani L, Odicino F. Revised FIGO staging for carcinoma of the cervix. Int J Gynaecol Obstet. 2009;105(2):107–8.PubMedCrossRefGoogle Scholar
  92. Pichler BJ, Wehrl HF, Kolb A, Judenhofer MS. Positron emission tomography/magnetic resonance imaging: the next generation of multimodality imaging? Semin Nucl Med. 2008;38(3):199–208.PubMedPubMedCentralCrossRefGoogle Scholar
  93. Piver MS, Chung WS. Prognostic significance of cervical lesion size and pelvic node metastases in cervical carcinoma. Obstet Gynecol. 1975;46(5):507–10.PubMedGoogle Scholar
  94. Qayyum A, Coakley FV, Westphalen AC, Hricak H, Okuno WT, Powell B. Role of CT and MR imaging in predicting optimal cytoreduction of newly diagnosed primary epithelial ovarian cancer. Gynecol Oncol. 2005;96(2):301–6.PubMedCrossRefGoogle Scholar
  95. Qin Y, Peng Z, Lou J, Liu H, Deng F, Zheng Y. Discrepancies between clinical staging and pathological findings of operable cervical carcinoma with stage IB-IIB: a retrospective analysis of 818 patients. Aust N Z J Obstet Gynaecol. 2009;49(5):542–4.PubMedCrossRefGoogle Scholar
  96. Queiroz MA, Kubik-Huch RA, Hauser N, Freiwald-Chilla B, von Schulthess G, Froehlich JM, et al. PET/MRI and PET/CT in advanced gynaecological tumours: initial experience and comparison. Eur Radiol. 2015;25(8):2222–30.PubMedCrossRefGoogle Scholar
  97. Querleu D, Planchamp F, Narducci F, Morice P, Joly F, Genestie C, et al. Clinical practice guidelines for the management of patients with endometrial cancer in France. Recommendations of the Institut National du Cancer and the Societe Francaise d'Oncologie Gynecologique. Int J Gynecol Cancer. 2011;21(5):945–50.PubMedCrossRefGoogle Scholar
  98. Rockall AG, Meroni R, Sohaib SA, Reynolds K, Alexander-Sefre F, Shepherd JH, et al. Evaluation of endometrial carcinoma on magnetic resonance imaging. Int J Gynecol Cancer. 2007;17(1):188–96.PubMedCrossRefGoogle Scholar
  99. Romeo V, D'Aiuto M, Frasci G, Imbriaco M, Nicolai E. Simultaneous PET/MRI assessment of response to cytotoxic and hormone neo-adjuvant chemotherapy in breast cancer: a preliminary report. Med Oncol. 2017;34(2):18.PubMedCrossRefGoogle Scholar
  100. Sala E, Rockall AG, Freeman SJ, Mitchell DG, Reinhold C. The added role of MR imaging in treatment stratification of patients with gynecologic malignancies: what the radiologist needs to know. Radiology. 2013;266(3):717–40.PubMedCrossRefGoogle Scholar
  101. Sala E, Wakely S, Senior E, Lomas D. MRI of malignant neoplasms of the uterine corpus and cervix. AJR Am J Roentgenol. 2007;188(6):1577–87.PubMedCrossRefGoogle Scholar
  102. Sawicki LM, Grueneisen J, Buchbender C, Schaarschmidt BM, Gomez B, Ruhlmann V, et al. Evaluation of the outcome of lung nodules missed on 18F-FDG PET/MRI compared with 18F-FDG PET/CT in patients with known malignancies. J Nucl Med. 2016a;57(1):15–20.PubMedCrossRefGoogle Scholar
  103. Sawicki LM, Grueneisen J, Buchbender C, Schaarschmidt BM, Gomez B, Ruhlmann V, et al. Comparative performance of 18F-FDG PET/MRI and 18F-FDG PET/CT regarding detection and characterization of pulmonary lesions in 121 oncologic patients. J Nucl Med. 2016b;Google Scholar
  104. Schafer JF, Gatidis S, Schmidt H, Guckel B, Bezrukov I, Pfannenberg CA, et al. Simultaneous whole-body PET/MR imaging in comparison to PET/CT in pediatric oncology: initial results. Radiology. 2014;273(1):220–31.PubMedCrossRefGoogle Scholar
  105. Schmidt S, Meuli RA, Achtari C, Prior JO. Peritoneal carcinomatosis in primary ovarian cancer staging: comparison between MDCT, MRI, and 18F-FDG PET/CT. Clin Nucl Med. 2015;40(5):371–7.PubMedCrossRefGoogle Scholar
  106. Selman TJ, Mann C, Zamora J, Appleyard TL, Khan K. Diagnostic accuracy of tests for lymph node status in primary cervical cancer: a systematic review and meta-analysis. CMAJ. 2008;178(7):855–62.PubMedPubMedCentralCrossRefGoogle Scholar
  107. Siegel R, Ma J, Zou Z, Jemal A. Cancer statistics, 2014. CA Cancer J Clin. 2014;64(1):9–29.PubMedCrossRefGoogle Scholar
  108. Sohaib SA, Houghton SL, Meroni R, Rockall AG, Blake P, Reznek RH. Recurrent endometrial cancer: patterns of recurrent disease and assessment of prognosis. Clin Radiol. 2007;62(1):28–34. discussion 5-6PubMedCrossRefGoogle Scholar
  109. Sotoudeh H, Sharma A, Fowler KJ, McConathy J, Dehdashti F. Clinical application of PET/MRI in oncology. J Magn Reson Imaging. 2016;44(2):265–76.PubMedCrossRefGoogle Scholar
  110. Stehman FB, Bundy BN, DiSaia PJ, Keys HM, Larson JE, Fowler WC. Carcinoma of the cervix treated with radiation therapy. I. A multi-variate analysis of prognostic variables in the Gynecologic Oncology Group. Cancer. 1991;67(11):2776–85.PubMedCrossRefGoogle Scholar
  111. Tinga DJ, Timmer PR, Bouma J, Aalders JG. Prognostic significance of single versus multiple lymph node metastases in cervical carcinoma stage IB. Gynecol Oncol. 1990;39(2):175–80.PubMedCrossRefGoogle Scholar
  112. Todo Y, Kato H, Kaneuchi M, Watari H, Takeda M, Sakuragi N. Survival effect of para-aortic lymphadenectomy in endometrial cancer (SEPAL study): a retrospective cohort analysis. Lancet. 2010;375(9721):1165–72.PubMedCrossRefGoogle Scholar
  113. Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015;65(2):87–108.PubMedCrossRefGoogle Scholar
  114. van Timmeren JE, Leijenaar RTH, van Elmpt W, Reymen B, Oberije C, Monshouwer R, et al. Survival prediction of non-small cell lung cancer patients using radiomics analyses of cone-beam CT images. Radiother Oncol. 2017;Google Scholar
  115. Vesselle HJ, Miraldi FD. FDG PET of the retroperitoneum: normal anatomy, variants, pathologic conditions, and strategies to avoid diagnostic pitfalls. Radiographics. 1998;18(4):805–23. discussion 23-4PubMedCrossRefGoogle Scholar
  116. Weber TM, Sostman HD, Spritzer CE, Ballard RL, Meyer GA, Clark-Pearson DL, et al. Cervical carcinoma: determination of recurrent tumor extent versus radiation changes with MR imaging. Radiology. 1995;194(1):135–9.PubMedCrossRefGoogle Scholar
  117. Yin Q, Hung SC, Wang L, Lin W, Fielding JR, Rathmell WK, et al. Associations between tumor vascularity, vascular endothelial growth factor expression and PET/MRI radiomic signatures in primary clear-cell-renal-cell-carcinoma: proof-of-concept study. Sci Rep. 2017;7:43356.PubMedPubMedCentralCrossRefGoogle Scholar
  118. Yuan Y, ZX G, Tao XF, Liu SY. Computer tomography, magnetic resonance imaging, and positron emission tomography or positron emission tomography/computer tomography for detection of metastatic lymph nodes in patients with ovarian cancer: a meta-analysis. Eur J Radiol. 2012;81(5):1002–6.PubMedCrossRefGoogle Scholar
  119. Zand KR, Reinhold C, Abe H, Maheshwari S, Mohamed A, Upegui D. Magnetic resonance imaging of the cervix. Cancer Imaging. 2007;7:69–76.PubMedPubMedCentralCrossRefGoogle Scholar
  120. Zhou Y, He L, Huang Y, Chen S, Wu P, Ye W, et al. CT-based radiomics signature: a potential biomarker for preoperative prediction of early recurrence in hepatocellular carcinoma. Abdom Radiol. 2017;42(6):1695–704.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Department of Diagnostic and Interventional Radiology and NeuroradiologyUniversity Hospital EssenEssenGermany

Personalised recommendations