Positron Emission Tomography-Magnetic Resonance Imaging in Oncologic Diseases of the Male and Female Pelvis

Abstract

Introduction Thehuman pelvis harbors a variety of organs and structures that can be at the origin of developing neoplasms. The clinical and diagnostic workup, the staging, and the appropriate treatment and disease follow-up of these neoplasms are diverse and complex anddependon the organ and tumor type, among other factors. Similarly, the individual diagnostic algorithms and the value of imaging in these algorithms vary between organs and tumor types. The possibility to directly access the target tissue and organ via percutaneous, transrectal, transvaginal, or transurethral approaches offers many options for the diagnosis and staging of the disease and may make one think that imaging is a less requested diagnostic tool. At the same time, a large variety of imaging modalities are nowadays available to assist in the diagnostic workup of oncologic diseases in general and in the diseases of the pelvis in particular. Although constantly improving imaging technology and newly developing imaging techniques are at the disposition of the clinician, oftentimes their diagnostic effect and evidence-based value seem underestimated or remain to be determined. Conversely, for many oncologic diseases of the pelvis, the value of imaging in diagnosing and staging is well established, documented, and accepted knowledge. Ultrasound (US) of the female pelvis, as an example, is a cost-effective and widely and readily available imaging tool, providing comprehensive information in most instances, despite being operator dependent. The endovaginal approach significantly improves its diagnostic performance. Computed tomography (CT) is the standard of care to assess the metastatic spread of disease for pelvic malignancies. To complement the diagnostic value of CT with functional