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20.05.2017 | Pictorial Essay | Ausgabe 10/2017

Abdominal Radiology 10/2017

Fertility-sparing for young patients with gynecologic cancer: How MRI can guide patient selection prior to conservative management

Zeitschrift:
Abdominal Radiology > Ausgabe 10/2017
Autoren:
Sinead H. McEvoy, Stephanie Nougaret, Nadeem R. Abu-Rustum, Hebert Alberto Vargas, Elizabeth A. Sadowski, Christine O. Menias, Fuki Shitano, Shinya Fujii, Ramon E. Sosa, Joanna G. Escalon, Evis Sala, Yulia Lakhman
Wichtige Hinweise
The original version of this article is revised: “The figures 7D, 7E and 7F were missing in the article and arrows were missing in the figures 6C, 8B and 11C. The year of publication and volume number for references 19, 79 and 87 have been updated. The above mistakes are corrected through erratum. Also, the Table 2 layout has been improved for better readability”. The Publisher apologizes for the mistakes and the inconvenience caused.
CME activity This article has been selected as the CME activity for the current month. Please visit https://​ce.​mayo.​edu/​node/​46007 and follow the instructions to complete this CME activity.
An erratum to this article is available at https://​doi.​org/​10.​1007/​s00261-017-1205-5.

Abstract

Historically, cancer treatment has emphasized measures for the “cure” regardless of the long-term consequences. Advances in cancer detection and treatment have resulted in improved outcomes bringing to the fore various quality of life considerations including future fertility. For many young cancer patients, fertility preservation is now an integral component of clinical decision-making and treatment design. Optimal fertility-sparing options for young patients with gynecologic cancer are influenced by patient age, primary cancer, treatment regimens, and patient preferences. Possible approaches include embryo or oocyte cryopreservation, ovarian transposition, conservative surgery, and conservative medical treatment to delay radical surgery. These may be used alone or in combination to maximize fertility preservation. Awareness of the various fertility-sparing options, eligibility criteria, and the central role of magnetic resonance imaging in the proper selection of patients will enable radiologists to produce complete clinically relevant imaging reports and serve as effective consultants to referring clinicians. Knowledge of the potential imaging pitfalls is essential to avoid misinterpretation and guide appropriate management.

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