Evaluation of gynecologic cancer with MR imaging, 18F-FDG PET/CT, and PET/MR imaging

J Nucl Med. 2015 Mar;56(3):436-43. doi: 10.2967/jnumed.114.145011. Epub 2015 Jan 29.


MR imaging and (18)F-FDG PET/CT play central and complementary roles in the care of patients with gynecologic cancer. Because treatment often requires combinations of surgery, radiotherapy, and chemotherapy, imaging is central to triage and to determining prognosis. This article reviews the use of the 2 imaging modalities in the initial evaluation of 3 common cancers: uterine cervical, uterine endometrial, and epithelial ovarian. Imaging features that affect management are highlighted, as well as the relative strengths and weaknesses of the 2 modalities. Use of imaging after initial therapy to assess for recurrence and to plan salvage therapy is described. Newer functional and molecular techniques in MR imaging and PET are evaluated. Finally, we describe our initial experience with PET/MR imaging, an emerging technology that may prove to be a mainstay in personalized gynecologic cancer care.

Keywords: 16α-18F-fluoro-17β-estradiol PET; Cu-labeled diacetyl-bis (N4-methylthiosemicarbazone) PET; diffusion weighted imaging; dynamic contrast enhanced MRI; perfusion MRI.

Publication types

  • Review

MeSH terms

  • Coordination Complexes
  • Estradiol / analogs & derivatives
  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Magnetic Resonance Imaging*
  • Multimodal Imaging
  • Neoplasm Recurrence, Local
  • Organometallic Compounds / chemistry
  • Ovarian Neoplasms / diagnosis*
  • Ovarian Neoplasms / diagnostic imaging
  • Ovarian Neoplasms / pathology
  • Positron-Emission Tomography*
  • Prognosis
  • Salvage Therapy
  • Thiosemicarbazones / chemistry
  • Tomography, X-Ray Computed*
  • Uterine Cervical Neoplasms / diagnosis*
  • Uterine Cervical Neoplasms / diagnostic imaging
  • Uterine Cervical Neoplasms / pathology
  • Uterine Neoplasms / diagnosis*
  • Uterine Neoplasms / diagnostic imaging
  • Uterine Neoplasms / pathology


  • Coordination Complexes
  • Organometallic Compounds
  • Thiosemicarbazones
  • copper (II) diacetyl-di(N(4)-methylthiosemicarbazone)
  • Fluorodeoxyglucose F18
  • Estradiol
  • 16-fluoroestradiol