title: Gestational Trophoblastic Disease: Clinical and Imaging Features.
abstract: Gestational trophoblastic disease (GTD) is a spectrum of both benign and malignant gestational tumors, including hydatidiform mole (complete and partial), invasive mole, choriocarcinoma, placental site trophoblastic tumor, and epithelioid trophoblastic tumor. The latter four entities are referred to as gestational trophoblastic neoplasia (GTN). These conditions are aggressive with a propensity to widely metastasize. GTN can result in significant morbidity and mortality if left untreated. Early diagnosis of GTD is essential for prompt and successful management while preserving fertility. Initial diagnosis of GTD is based on a multifactorial approach consisting of clinical features, serial quantitative human chorionic gonadotropin (β-hCG) titers, and imaging findings. Ultrasonography (US) is the modality of choice for initial diagnosis of complete hydatidiform mole and can provide an invaluable means of local surveillance after treatment. The performance of US in diagnosing all molar pregnancies is surprisingly poor, predominantly due to the difficulty in differentiating partial hydatidiform mole from nonmolar abortion and retained products of conception. While GTN after a molar pregnancy is usually diagnosed with serial β-hCG titers, imaging plays an important role in evaluation of local extent of disease and systemic surveillance. Imaging also plays a crucial role in detection and management of complications, such as uterine and pulmonary arteriovenous fistulas. Familiarity with the pathogenesis, classification, imaging features, and treatment of these tumors can aid in radiologic diagnosis and guide appropriate management.©RSNA, 2017.
authors.affiliation: From the Department of Radiology and Imaging Sciences (A.M.S., M.R., R.R.H., A.M.K., J.D.O.) and Department of Pathology (M.E.S.), University of Utah, 30 North 1900 East, #1A71, Salt Lake City, UT 84132; Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.); Department of Diagnostic Radiology, Oregon Health & Science University, Portland, Ore (B.R.F.); and Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.O.M.).
authors.forename: Akram M
authors.initials: AM
authors.lastname: Shaaban
authors.affiliation: From the Department of Radiology and Imaging Sciences (A.M.S., M.R., R.R.H., A.M.K., J.D.O.) and Department of Pathology (M.E.S.), University of Utah, 30 North 1900 East, #1A71, Salt Lake City, UT 84132; Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.); Department of Diagnostic Radiology, Oregon Health & Science University, Portland, Ore (B.R.F.); and Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.O.M.).
authors.forename: Maryam
authors.initials: M
authors.lastname: Rezvani
authors.affiliation: From the Department of Radiology and Imaging Sciences (A.M.S., M.R., R.R.H., A.M.K., J.D.O.) and Department of Pathology (M.E.S.), University of Utah, 30 North 1900 East, #1A71, Salt Lake City, UT 84132; Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.); Department of Diagnostic Radiology, Oregon Health & Science University, Portland, Ore (B.R.F.); and Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.O.M.).
authors.forename: Reham R
authors.initials: RR
authors.lastname: Haroun
authors.affiliation: From the Department of Radiology and Imaging Sciences (A.M.S., M.R., R.R.H., A.M.K., J.D.O.) and Department of Pathology (M.E.S.), University of Utah, 30 North 1900 East, #1A71, Salt Lake City, UT 84132; Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.); Department of Diagnostic Radiology, Oregon Health & Science University, Portland, Ore (B.R.F.); and Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.O.M.).
authors.forename: Anne M
authors.initials: AM
authors.lastname: Kennedy
authors.affiliation: From the Department of Radiology and Imaging Sciences (A.M.S., M.R., R.R.H., A.M.K., J.D.O.) and Department of Pathology (M.E.S.), University of Utah, 30 North 1900 East, #1A71, Salt Lake City, UT 84132; Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.); Department of Diagnostic Radiology, Oregon Health & Science University, Portland, Ore (B.R.F.); and Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.O.M.).
authors.forename: Khaled M
authors.initials: KM
authors.lastname: Elsayes
authors.affiliation: From the Department of Radiology and Imaging Sciences (A.M.S., M.R., R.R.H., A.M.K., J.D.O.) and Department of Pathology (M.E.S.), University of Utah, 30 North 1900 East, #1A71, Salt Lake City, UT 84132; Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.); Department of Diagnostic Radiology, Oregon Health & Science University, Portland, Ore (B.R.F.); and Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.O.M.).
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Olpin
authors.affiliation: From the Department of Radiology and Imaging Sciences (A.M.S., M.R., R.R.H., A.M.K., J.D.O.) and Department of Pathology (M.E.S.), University of Utah, 30 North 1900 East, #1A71, Salt Lake City, UT 84132; Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.); Department of Diagnostic Radiology, Oregon Health & Science University, Portland, Ore (B.R.F.); and Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.O.M.).
authors.forename: Mohamed E
authors.initials: ME
authors.lastname: Salama
authors.affiliation: From the Department of Radiology and Imaging Sciences (A.M.S., M.R., R.R.H., A.M.K., J.D.O.) and Department of Pathology (M.E.S.), University of Utah, 30 North 1900 East, #1A71, Salt Lake City, UT 84132; Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.); Department of Diagnostic Radiology, Oregon Health & Science University, Portland, Ore (B.R.F.); and Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.O.M.).
authors.forename: Bryan R
authors.initials: BR
authors.lastname: Foster
authors.affiliation: From the Department of Radiology and Imaging Sciences (A.M.S., M.R., R.R.H., A.M.K., J.D.O.) and Department of Pathology (M.E.S.), University of Utah, 30 North 1900 East, #1A71, Salt Lake City, UT 84132; Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.); Department of Diagnostic Radiology, Oregon Health & Science University, Portland, Ore (B.R.F.); and Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.O.M.).
authors.forename: Christine O
authors.initials: CO
authors.lastname: Menias
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood*; D003937:Diagnosis, Differential; D005260:Female; D031901:Gestational Trophoblastic Disease / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D006801:Humans; D011247:Pregnancy
chemical_list: D014408:Biomarkers, Tumor