[The value of MRI in staging gynecologic tumors]

Traditionally gynecologic malignancies are staged by examination under anaesthesia which provides high accuracy as far as small tumors are concerned. In advanced tumors clinical staging is often inaccurate because of the difficulty to evaluate parametrial or myometrial tumor infiltration or lymphatic tumor spread. Therefore imaging modalities, such as sonography, computed tomography (CT), and magnetic resonance imaging (MRI), are required in most cases. The range of applications for MRI imaging includes staging, therapy planning, and follow-up examinations of uterine tumors and recurrent carcinoma. Based on its excellent soft tissue contrast, which allows a precise differentiation between several tissues and its direct multiplanar imaging capability, MRI is superior to sonography and CT. Only in the staging of ovarian carcinoma has the value of MRT not yet been defined, nevertheless it seems to offer diagnostic advantages over CT and sonography on account of its higher specificity. CT lose some of its value after the introduction of MRI into clinical practice. Indications for the use of CT are advanced space-occupying tumors with lymphatic spread or peritoneal implants as well as monitoring the tumor response to therapy for ovarian cancer. Sonography, as the technically simplest imaging modality, has consistently demonstrated its value as a screening method in the evaluation of benign gynecologic disease and is traditionally used for the detection of ovarian masses.