Functional assessment in endometrial and cervical cancer: diffusion and perfusion, two captivating tools for radiologists

Uterine cervical and endometrial cancers are two major gynecological malignancies, affecting women's health worldwide. Magnetic resonance imaging (MRI) is appropriate for evaluating malignant disease, thanks to the excellent soft tissue contrast and multiplanar imaging ability. Recently, functional MR techniques, namely diffusion-weighted imaging (DWI) and dynamic contrast-enhanced imaging (DCE), have proved to be a precious support not only in cancer diagnosis but also in disease staging, in the therapy planning, in monitoring response to treatment and during long-term recurrence surveillance. In the field of gynecologic oncology, the European Society of Urogenital Radiology (ESUR) recommends DWI and dynamic contrast-enhanced imaging (DCE-MRI) for local staging of endometrial and cervical cancer, but the potential application of functional imaging in all different aspects of patient management seems very promising. The aim of this article is to summarize the existing literature, providing a comprehensive update on the role of functional MRI in endometrial and cervical cancer.

Diagnostic approach to focal liver lesions at cross-sectional imaging: a primer for beginners

Liver imaging encompasses a broad spectrum of diseases in different clinical backgrounds. The available literature is vast and reported data often lacks standardization. Because of all these issues, the differential diagnosis and the characterization of liver lesions can be challenging for the beginner. The aim of this narrative review is to provide the basics for an algorithm approach to liver lesions on cross-sectional imaging. First, some tips for the optimization of Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) protocols will be provided. Liver Imaging Reporting and Data System (LI-RADS, version 2018) working group is proposing the adoption of their standardized lexicon beyond the original target population of LI-RADS (i.e., liver cirrhosis). Thus, the main imaging findings will be defined following the LI-RADS lexicon. Since the contrast study is the most important for lesion characterization, this narrative review separates the lesions into avascular, hypovascular, and hypervascular, with a focus on chronic liver disease (CLD) and hepatocellular carcinoma (HCC).

Radiological assessment of peritoneal carcinomatosis: a primer for resident

The imaging has critical responsibility in the assessment of peritoneal lesions along with estimating the overall extent. Valuing disease burden is crucial for selection of combining cytoreductive surgery (CRS) and intraperitoneal hyperthermic chemotherapy (HIPEC) treatment. An approach that combines the strength of several imaging tools and increases diagnostic accuracy, should be chosen, even if the preferred imaging tool in patients with suspected Peritoneal Carcinomatosis (PC) is CT. The outcomes of PC are mainly correlated to tumor spread, localization, and lesion size. Accurate assessment of these features is critical for prognosis and treatment planning. These data can be evaluated by Peritoneal Cancer Index (PCI), a quantitative index suggested by Harman and Sugarbaker. Additionally, precise predictive biomarkers should be established to predict PC in patients at risk. The radiomics analysis could predict PC throughout the evaluation of cancers heterogeneity.