The lecture will include the clinical usages of recent MR techniques for the assessment of gynecologic cancer patients.
Target Audience: Clinical doctors who are interested in gynecologic oncology
Recent advance in MRI change diagnosis of the diseases from the morphological analysis to functional analysis such as Diffusion weighted image (DWI) and perfusion imaging. Although morphological assessment by MR imaging plays an important role in the management of patients with a malignancy, there are many limitations such as early detection of both primary and recurrent tumor, as well as evaluation of tumor viability during and after the treatment. For oncologic imaging, those functional techniques have a potential to detect microscopic changes in tumor by observing alterations in perfusion, oxygenation, and metabolism, which are considered to reflect tissue microenvironment and tissue cytoarchitecture. Such imaging parameters can be recognized as an "imaging biomarker". These information will be helpful not only for diagnosis, but also for evaluation of treatment response after chemotherapy or radiation, for differentiating post-therapeutic changes from residual active tumor, and for detecting recurrent cancer. Many trials have been reported regarding gynecologic cancer patients. In this lecture, several reports about tumor response to the therapy using imaging biomarkers will be introduced. The assessment of lymph node metastases also required for the estimation of patients prognosis. Since evaluation using size criterion has limitation, combined usage of DWI and T2WI is suggested for the improved detectability of LNs, though the discrimination of malignant LNs from benign by using ADC value is still in discussion. The lecture will include the clinical usages of recent MR techniques for the assessment of prognosis in gynecologic cancer patients.