PET/MRI is useful for early detection of pelvic insufficiency fractures after radiotherapy for cervical cancer

Update on Positron Emission Tomography/Magnetic Resonance Imaging: Cancer and Inflammation Imaging in the Clinic

Hybrid PET/MRI is highly valuable, having made significant strides in overcoming technical challenges and offering unique advantages such as reduced radiation, precise data coregistration, and motion correction. Growing evidence highlights the value of PET/MRI in broad clinical aspects, including inflammatory and oncological imaging in adults, pregnant women, and pediatrics, potentially surpassing PET/CT. This newly integrated solution may be preferred over PET/CT in many clinical conditions. However, further technological advancements are required to facilitate its broader adoption as a routine diagnostic modality.

Current Update on PET/MRI in Gynecological Malignancies-A Review of the Literature

Early detection of gynecological malignancies is vital for patient management and prolonging the patient's survival. Molecular imaging, such as positron emission tomography (PET)/computed tomography, has been increasingly utilized in gynecological malignancies. PET/magnetic resonance imaging (MRI) enables the assessment of gynecological malignancies by combining the metabolic information of PET with the anatomical and functional information from MRI. This article will review the updated applications of PET/MRI in gynecological malignancies.

Effects of Radiation Therapy and Chemotherapy on the Musculoskeletal System

The effects of radiation and chemotherapy on the musculoskeletal (MSK) system are diverse, and interpretation may be challenging. The different lines of treatment have effects on diseased and normal marrow, and they may lead to complications that must be differentiated from recurrence or progression. This review analyzes the changes induced by radiotherapy and chemotherapy in the MSK system in the adult and pediatric population, and the expected associated imaging findings. Treatments are often combined, so the effects may blend. Awareness of the spectrum of changes, complications, and their imaging appearances is paramount for the correct diagnosis. The assessment of body composition during and after treatment allows potential interventions to implement long-term outcomes and personalize treatments. Imaging techniques such as computed tomography or magnetic resonance imaging provide information on body composition that can be incorporated into clinical pathways. We also address future perspectives in posttreatment assessment.

Significance of Magnetic Resonance Imaging Combining with Detection of Serum HE4, TSGF, and CD105 Levels in Diagnosis and Treatment of Moderate to Advanced Cervical Cancer

Objective. To explore the significance of magnetic resonance imaging (MRI) combining with detection of serum HE4, TSGF, and CD105 levels in diagnosis and treatment of moderate to advanced cervical cancer. Methods. By means of retrospective study, 50 patients diagnosed with moderate to advanced cervical cancer by cervix biopsy pathology examination in our hospital from October 2018 to October 2019 were selected as the study group, and another 50 healthy individuals who did not have cervical cancer after routine gynecological examination and conventional ultrasound examination in the same period were selected as the control group. At the time of enrollment and 3 months after treatment, all study subjects received MRI examination and serological examination, and their HE4 and TSGF levels were measured by the enzyme-linked immunosorbent assay (ELISA) and chromatography method, respectively, and additionally, the immunohistochemistry SP method was adopted for patients in the study group to measure the microvessel density (MVD) marked by CD105. The relationship between MRI staging and FIGO staging was assessed, the efficacy of combining MRI with detection of serum HE4, TSGF, and CD105 levels in diagnosing moderate to advanced cervical cancer was calculated by plotting the ROC curve, and the imaging changes and serological changes of tumor tissue before and after treatment were analyzed. Results. There were 3 of 4 patients in stage IIa and 14 of 15 patients in stage IIIb presenting MRI findings compatible with clinical examinations; 26 patients in stage IIb and 5 patients in stage IVb presenting MRI findings totally compatible with clinical examination. Before treatment, MRI finding of cervical lesion was irregular soft tissue mass, T1WI appeared isointensity or hyperintensity, and obvious lesion enhancement could be seen by enhanced scan. T2WI appeared mixed signal intensity or hyperintensity, with necrotic tissue and fat suppression being hyperintensity. After treatment, lesions shrunk, originally abnormal signals in 5 patients disappeared, and T1WI and T2WI signals in 45 patients presented no difference compared to before treatment. After T1WI enhancement, mild enhancement could be seen in 41 cases and no enhancement in 4 cases. The CD105-MVD of the study group was (68.98 ± 5.23); before and after treatment, the differences in HE4 and TSGF levels between the study group and the control group were significant ( $P<0.001$ ). The sensitivity, specificity, and accuracy rate of diagnosis of MRI diagnosis were respectively 82.0% (41/50), 90.0% (45/50), and 86.0% (86/100), and for the diagnosis combining with serum HE4, TSGF, and CD105 levels, they were 96.0% (48/50), 96.0% (48/50), and 96.0% (96/100), respectively, and AUC (95% CI) = 0.960 (0.908–1.000). Conclusion. MRI staging is objective and accurate and has higher sensitivity when combined with serum HE4, TSGF, and CD105 levels in diagnosing moderate to advanced cervical cancer. All MRI, HE4, and TSGF can reflect the treatment effect of patients and are of great importance to efficacy assessment.