Gestational Trophoblastic Disease: Clinical and Imaging Features

Area of Science:

• Radiology
• Gynecologic Oncology
• Pathology

Background:

• Gestational trophoblastic disease (GTD) is a group of pregnancy-related tumors, ranging from benign hydatidiform moles to malignant gestational trophoblastic neoplasia (GTN).
• GTN is aggressive, prone to metastasis, and can cause significant morbidity and mortality if untreated.
• Early diagnosis and prompt management of GTD are vital for successful treatment outcomes and fertility preservation.

Purpose of the Study:

• To review the pathogenesis, classification, and imaging features of GTD.
• To highlight the role of imaging in the diagnosis, surveillance, and management of GTD and its complications.
• To emphasize the importance of radiologic expertise in guiding patient management.

Main Methods:

• Review of literature on gestational trophoblastic disease.
• Discussion of diagnostic imaging modalities, primarily ultrasonography (US).
• Correlation of imaging findings with clinical features and human chorionic gonadotropin (β-hCG) levels.

Main Results:

• Ultrasonography is the primary imaging modality for diagnosing complete hydatidiform mole and for post-treatment surveillance.
• US performance in diagnosing all molar pregnancies is limited, particularly in differentiating partial hydatidiform mole from non-molar conditions.
• Imaging is essential for evaluating local disease extent, systemic surveillance, and managing complications like arteriovenous fistulas.

Conclusions:

• Accurate diagnosis of GTD relies on a multifactorial approach including clinical presentation, serial β-hCG titers, and imaging.
• While β-hCG monitoring is key for GTN diagnosis, imaging plays a critical role in comprehensive patient evaluation and management.
• Familiarity with GTD imaging characteristics aids radiologists in diagnosis and treatment planning.