%0 Journal Article
%T Gestational Trophoblastic Disease: A Multimodality Imaging Approach with Impact on Diagnosis and Management
%A Sunita Dhanda
%A Subhash Ramani
%A Meenkashi Thakur
%J Radiology Research and Practice
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/842751
%X Gestational trophoblastic disease is a condition of uncertain etiology, comprised of hydatiform mole (complete and partial), invasive mole, choriocarcinoma, and placental site trophoblastic tumor. It arises from abnormal proliferation of trophoblastic tissue. Early diagnosis of gestational trophoblastic disease and its potential complications is important for timely and successful management of the condition with preservation of fertility. Initial diagnosis is based on a multimodality approach: encompassing clinical features, serial quantitative ¦Â-hCG titers, and pelvic ultrasonography. Pelvic magnetic resonance imaging (MRI) is sometimes used as a problem-solving tool to assess the depth of myometrial invasion and extrauterine disease spread in equivocal and complicated cases. Chest radiography, body computed tomography (CT), and brain MRI have been recommended as investigative tools for overall disease staging. Angiography has a role in management of disease complications and metastases. Efficacy of PET (positron emission tomography) and PET/CT in the evaluation of recurrent or metastatic disease has not been adequately investigated yet. This paper discusses the imaging features of gestational trophoblastic disease on various imaging modalities and the role of different imaging techniques in the diagnosis and management of this entity. 1. Introduction Gestational trophoblastic disease (GTD) refers to an abnormal trophoblastic proliferation composed of a broad spectrum of lesions ranging from benign, albeit premalignant hydatiform mole (complete and partial), through to the aggressive invasive mole, choriocarcinoma, and placental site trophoblastic tumor (PSTT). Gestational trophoblastic neoplasia (GTN) refers to the aggressive subset that has a capability for independent growth and metastases and requires chemotherapy. It includes invasive mole, choriocarcinoma, and PSTT. GTN may arise following evacuation of a molar pregnancy as well as after a normal term or preterm pregnancy, abortion, or ectopic pregnancy. Hence, it is also referred to as persistent trophoblastic neoplasia (PTN). These lesions vary considerably in clinicopathologic behavior and propensity for local invasion and metastases. Although GTD may occur as a pregnancy complication in women of any age, it is more common at teenage or advanced maternal age (40¨C50 years) [1, 2]. Early detection of GTN is important as it has an excellent prognosis following treatment due to exquisite chemosensitivity of most of these lesions [1, 2]. In this paper, we describe the role of various imaging
%U http://www.hindawi.com/journals/rrp/2014/842751/