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Is My Mouse Pregnant? High-Frequency Ultrasound Assessment
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Imaging Cancer in Pregnancy.

Priyanka Jha1, Liina Pōder1, Phyllis Glanc1

  • 1From the Department of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Ave, Box 0628, San Francisco, CA 94143 (P.J., L.P.); Department of Radiology, Obstetrics and Gynecology, University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada (P.G.); Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tenn (K.P.L., M. Moshiri); Department of Diagnostic Imaging and Interventional Radiology, Moffitt Cancer Center, and Department of Oncologic Sciences, University of South Florida College of Medicine, Tampa, Fla (M. McGettigan); Department of Radiology, Institut Régional du Cancer de Montpellier, University of Montpellier, Montpellier, France (S.N.); Montpellier Cancer Research Institute, University of Montpellier, Montpellier, France (S.N.); Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Conn (M.V.R.); Department of Radiology, George Washington University Medical Center, Washington, DC (M.C.J.); and Department of Medical Imaging, Rambam Health Care Campus, Haifa, Israel (M.C.J.).

Radiographics : a Review Publication of the Radiological Society of North America, Inc
|July 15, 2022
PubMed
Summary

Pregnancy-associated cancer (PAC) is increasing. Imaging and multidisciplinary care are crucial for diagnosis and treatment, balancing maternal and fetal safety. Whole-body MRI is ideal for staging.

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Area of Science:

  • Radiology
  • Oncology
  • Maternal-Fetal Medicine

Background:

  • Pregnancy-associated cancer (PAC) is cancer diagnosed during pregnancy or up to one year postpartum.
  • PAC incidence is rising due to delayed childbearing and advanced maternal age.
  • Physiologic changes in pregnancy can mask cancer symptoms, delaying diagnosis.

Purpose of the Study:

  • To provide an update on imaging triage, safety considerations, and treatment options for PAC.
  • To emphasize the importance of a multidisciplinary team approach in managing PAC.
  • To review imaging modalities and contrast agent safety during pregnancy.

Main Methods:

  • Review of current literature and guidelines on imaging and management of PAC.
  • Discussion of safety considerations for various imaging modalities, including radiation exposure and contrast agents.
  • Highlighting the role of whole-body MRI with diffusion-weighted sequences for staging.

Main Results:

  • Ultrasound (US) and MRI are preferred imaging modalities due to lack of ionizing radiation.
  • Most imaging examinations involve radiation levels below thresholds for deterministic side effects.
  • Iodinated contrast is safe; gadolinium-based contrast should be avoided during pregnancy.
  • Whole-body MRI is effective for screening, staging, and guiding biopsies in PAC.

Conclusions:

  • Accurate diagnosis and staging, considering gestational age, are vital for treatment decisions.
  • A multidisciplinary team approach is essential for optimal patient care in PAC.
  • Balancing maternal and fetal safety with effective cancer treatment requires careful consideration of imaging and therapeutic strategies.