title: Which imaging technique should we use in the follow up of gynaecological cancer?
abstract: Follow-up routines after gynaecological cancer vary. The optimal approach is unknown, and no randomised-controlled trials comparing surveillance protocols have been published. In this chapter, we summarise the diagnostic performance of ultrasound, computed tomography, and magnetic resonance imaging in the follow up of women treated for ovarian or uterine cancers. Computed tomography is today the standard imaging method for the follow up of women treated for endometrial, cervical, or ovarian cancer. Six-monthly or annual follow-up examinations have not been shown to positively affect survival. Instead, a combination of transvaginal and transabdominal ultrasound examination with clinical examination might be a more cost-effective strategy for early detection of recurrence. Positron-emission tomography might play a role in women with clinical or serological suspicion of recurrence but without evidence of disease at conventional diagnostic imaging. To create guidelines, more studies, preferably randomised-controlled trials, on follow-up strategies are needed.
authors.affiliation: Department of Obstetrics and Gynaecology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Antonia Carla
authors.initials: AC
authors.lastname: Testa
authors.affiliation: Department of Obstetrics and Gynaecology, Catholic University of the Sacred Heart, Rome, Italy. Electronic address: alessia.dilegge@virgilio.it.
authors.forename: Alessia
authors.initials: A
authors.lastname: Di Legge
authors.affiliation: Department of Obstetrics and Gynaecology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Bruna
authors.initials: B
authors.lastname: Virgilio
authors.affiliation: Department of Radiology, University of Verona, "G.B. Rossi" Hospital, Verona, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Bonatti
authors.affiliation: Department of Radiology, University of Verona, "G.B. Rossi" Hospital, Verona, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Manfredi
authors.affiliation: Department of Radiology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Paoletta
authors.initials: P
authors.lastname: Mirk
authors.affiliation: Institute of Nuclear Medicine, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Vittoria
authors.initials: V
authors.lastname: Rufini
mesh_terms: D003266:Continuity of Patient Care; D003952:Diagnostic Imaging; D016889:Endometrial Neoplasms / Q000175:diagnosis; D005260:Female; D005833:Genital Neoplasms, Female / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D010051:Ovarian Neoplasms / Q000175:diagnosis*; D049268:Positron-Emission Tomography; D012007:Rectum / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis; D014594:Uterine Neoplasms / Q000175:diagnosis; D014621:Vagina / Q000000981:diagnostic imaging
keywords: computed tomography; gynaecological cancer recurrences; imaging techniques; magnetic resonance imaging; positron emission tomography; ultrasound