Evaluation of gynecologic malignancy by magnetic resonance imaging

Currently, MR imaging has demonstrated the greatest accuracy and has potentially the greatest clinical utility for the staging of cervical carcinoma. Endometrial carcinoma also can be staged by MR imaging with reasonable accuracy, although the clinical indications for preoperative endometrial carcinoma staging are less clear. MR imaging has unparalleled capacity for the tissue characterization of adnexal disease and has demonstrated utility for diagnosis of common adnexal masses such as pedunculated leiomyoma, endometrioma, and ovarian dermoid. Its use in the evaluation or staging of ovarian, vaginal, and vulvar carcinoma has not been evaluated fully. MR imaging can demonstrate complications of radiation therapy and surgery and can distinguish most recurrent carcinomas from postradiation fibrosis. New techniques such as arrayed use of surface coils, endoluminal surface coils, fast spin-echo acquisitions, and contrast agents show promise for contributing to the already rapid pace of technologic advancement in the field of MR imaging of the female pelvis.