Image-Guided Radiotherapy for Gynecologic Malignancies: What the Radiologist Needs to Know

Megan C Jacobsen; Ekta Maheshwari; Ann H Klopp; Aradhana M Venkatesan

doi:10.1016/j.rcl.2023.02.012

Image-Guided Radiotherapy for Gynecologic Malignancies: What the Radiologist Needs to Know

Radiol Clin North Am. 2023 Jul;61(4):725-747. doi: 10.1016/j.rcl.2023.02.012.

Authors

Megan C Jacobsen¹, Ekta Maheshwari², Ann H Klopp³, Aradhana M Venkatesan⁴

Affiliations

¹ Division of Diagnostic Imaging, Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Unit 1472, Houston, TX 77030, USA. Electronic address: https://twitter.com/megjacobsen.
² Division of Abdominal Imaging, Department of Radiology, University of Pittsburgh Medical Center, PUH Suite E204, 200 Lothrop St, Pittsburgh, PA 15213, USA. Electronic address: https://twitter.com/dr_ektam.
³ Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX 77030, USA. Electronic address: https://twitter.com/AnnKloppMD.
⁴ Division of Diagnostic Imaging, Department of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Unit 1473, Houston, TX 77030, USA. Electronic address: avenkatesan@mdanderson.org.

PMID: 37169434
DOI: 10.1016/j.rcl.2023.02.012

Abstract

Pelvic imaging is integral to contemporary radiotherapy (RT) management of gynecologic malignancies. For cervical, endometrial, vulvar, and vaginal cancers, three-dimensional imaging modalities aid in tumor staging and RT candidate selection and inform treatment strategy, including RT planning, execution, and posttherapy surveillance. State-of-the-art care routinely incorporates magnetic resonance (MR) imaging, 18F-fluorodeoxyglucose-PET/computed tomography (CT), and CT to guide external beam RT and brachytherapy, allowing the customization of RT plans to maximize patient outcomes and reduce treatment-related toxicities. Follow-up imaging identifies radiation-resistant and recurrent disease as well as short-term and long-term toxicities from RT.

Keywords: Cervical cancer; Endometrial cancer; Gynecologic malignancies; Image-guided radiotherapy; Vaginal cancer; Vulvar cancer.

Publication types

Review

MeSH terms

Female
Genital Neoplasms, Female* / diagnostic imaging
Genital Neoplasms, Female* / radiotherapy
Humans
Positron-Emission Tomography / methods
Radiologists
Radiotherapy Planning, Computer-Assisted / methods
Radiotherapy, Image-Guided* / methods
Tomography, X-Ray Computed