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

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An Erratum to this article was published on 11 November 2017

This article has been updated

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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Change history

  • 11 November 2017

    The original version of this article unfortunately contained mistakes. 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. Also, the Table 2 layout has been improved for better readability. The Publisher apologizes for the mistakes and the inconvenience caused.

Abbreviations

ADC:

Apparent diffusion coefficient

D&C:

Dilatation and curettage

DCE-MRI:

Dynamic contrast-enhanced MRI

DWI:

Diffusion-weighted imaging

ESMO:

European Society for Medical Oncology

ESUR:

European Society of Urogenital Radiology

FDG:

Fluorodeoxyglucose

FIGO:

International Federation of Gynecology and Obstetrics

FST1WI:

Fat-saturated T1WI

JZ:

Junctional zone

LVSI:

Lymphovascular space invasion

MRI:

Magnetic resonance imaging

NCCN:

National Comprehensive Cancer Network

OHSS:

Ovarian hyperstimulation syndrome

PET/CT:

Positron emission tomography–computed tomography

PET/MRI:

Positron emission tomography–magnetic resonance imaging

USO:

Unilateral salpingo-oophorectomy

ROI:

Region of interest

SEE:

Subendometrial enhancement

SI:

Signal intensity

T1WI:

T1-Weighted imaging

T2WI:

T2-Weighted imaging

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Author notes

  1. Sinead H. McEvoy

    Present address: Department of Radiology, The Christie NHS Foundation, 550 Wilmslow Rd, Manchester, M20 4BX, UK

  2. Stephanie Nougaret

    Present address: Department of Radiology, Institut Régional du Cancer de Montpellier, Montpellier, France

  3. Fuki Shitano

    Present address: Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan

  4. Joanna G. Escalon

    Present address: Department of Radiology, New York-Presbyterian Hospital-Weill Cornell Medical Center, New York, NY, USA

Authors and Affiliations

  1. Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Sinead H. McEvoy, Stephanie Nougaret, Hebert Alberto Vargas, Fuki Shitano, Ramon E. Sosa, Joanna G. Escalon, Evis Sala & Yulia Lakhman

  2. Gynecologic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Nadeem R. Abu-Rustum

  3. Department of Radiology, University of Wisconsin, Madison, WI, USA

    Elizabeth A. Sadowski

  4. Department of Diagnostic Radiology, Mayo Clinic, Phoenix, AZ, USA

    Christine O. Menias

  5. Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, Yonago, Japan

    Shinya Fujii

  6. IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM, U1194, Montpellier, France

    Stephanie Nougaret

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Correspondence to Sinead H. McEvoy.

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Funding

This study was funded in part through the NIH/NCI Cancer Center Support Grant P30 CA008748.

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The authors declare that they have no conflict of interest.

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This review article does not contain any studies with human participants or animals performed by any of the authors.

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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.

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An erratum to this article is available at https://doi.org/10.1007/s00261-017-1205-5.

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McEvoy, S.H., Nougaret, S., Abu-Rustum, N.R. et al. Fertility-sparing for young patients with gynecologic cancer: How MRI can guide patient selection prior to conservative management. Abdom Radiol 42, 2488–2512 (2017). https://doi.org/10.1007/s00261-017-1179-3

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