Nevertheless, visualization of retroperitoneal or iliac lymph nodes is frequently limited using US because of patient body habitus and overlying bowel gas. Suspicious inguinal lymph nodes can be readily assessed by US and biopsied as needed. US Abdomen If solid abdominal organ metastatic disease is clinically suspected, then transabdominal US may be used [81]. Variant 4: Surveillance of asymptomatic patients with treated low- or intermediate-risk endometrial cancer. Recurrence rates for low- or intermediate-risk patients with EC are infrequent. Therefore, a recent review of posttreatment surveillance and diagnosis of recurrence in women with gynecologic cancers sponsored by the Society of Gynecologic Oncology recommends that radiologic evaluation be used only to investigate suspicion of recurrent disease because of symptoms or physical exam and not for routine surveillance after treatment [80]. MRI Pelvis There currently is not sufficient evidence in the literature to recommend routine surveillance by MRI for patients with low- or intermediate-risk EC [80]. MRI Abdomen MRI may also be used for assessment of metastasis of the liver, adrenals, brain, bones, and soft-tissue when metastases are clinically suspected and need further investigation. However, there is insufficient data to support the routine use of MRI for surveillance of asymptomatic patients [80]. CT Chest, Abdomen, and Pelvis A review of the literature found that only 5% to 21% of asymptomatic recurrences were detected by CT [87]. Another study reported that the role of CT scanning for asymptomatic patients is not warranted because survival of patients with disease that is detected on CT scan, compared with clinical examination, did not differ significantly [88]. Therefore, the use of routine CT scan is not useful for disease surveillance [19,89].
Pretreatment Evaluation and Follow Up of Endometrial Cancer. Nevertheless, visualization of retroperitoneal or iliac lymph nodes is frequently limited using US because of patient body habitus and overlying bowel gas. Suspicious inguinal lymph nodes can be readily assessed by US and biopsied as needed. US Abdomen If solid abdominal organ metastatic disease is clinically suspected, then transabdominal US may be used [81]. Variant 4: Surveillance of asymptomatic patients with treated low- or intermediate-risk endometrial cancer. Recurrence rates for low- or intermediate-risk patients with EC are infrequent. Therefore, a recent review of posttreatment surveillance and diagnosis of recurrence in women with gynecologic cancers sponsored by the Society of Gynecologic Oncology recommends that radiologic evaluation be used only to investigate suspicion of recurrent disease because of symptoms or physical exam and not for routine surveillance after treatment [80]. MRI Pelvis There currently is not sufficient evidence in the literature to recommend routine surveillance by MRI for patients with low- or intermediate-risk EC [80]. MRI Abdomen MRI may also be used for assessment of metastasis of the liver, adrenals, brain, bones, and soft-tissue when metastases are clinically suspected and need further investigation. However, there is insufficient data to support the routine use of MRI for surveillance of asymptomatic patients [80]. CT Chest, Abdomen, and Pelvis A review of the literature found that only 5% to 21% of asymptomatic recurrences were detected by CT [87]. Another study reported that the role of CT scanning for asymptomatic patients is not warranted because survival of patients with disease that is detected on CT scan, compared with clinical examination, did not differ significantly [88]. Therefore, the use of routine CT scan is not useful for disease surveillance [19,89].