Doppler US can also confirm the absence of vascular flow within a mass, a useful technique in patients with GTD where clot or blood products may simulate solid tissue. CT Head If physical examination and chest radiographs are normal in a patient with GTD, metastases to other sites are unlikely, and further imaging investigation is not indicated [37,43]. CT Abdomen and Pelvis If physical examination and chest radiographs are normal in a patient with GTD, metastases to other sites are unlikely, and further imaging investigation is not indicated [37,43]. Gestational Trophoblastic Disease MRI Head If physical examination and chest radiographs are normal in a patient with GTD, metastases to other sites are unlikely, and further imaging investigation is not indicated [37,43]. MRI Pelvis To our knowledge, there is no evidence to support the routine use of MRI for initial evaluation of known or suspected GTD. Evaluation of MRI in patients with hydatidiform mole is limited to small series and cases reports [44-46]. Diffusion-weighted imaging has been evaluated as a potential predictor of subsequent GTN development in a small retrospective study and was not found to be useful [46]. FDG-PET/CT Skull Base to Mid-Thigh To our knowledge, there is no evidence to support the routine use of fluorine-18-2-fluoro-2-deoxy-D-glucose (FDG)-PET/CT for initial evaluation of known or suspected GTD. Preliminary limited data suggest a potential role for FDG-PET/CT in the identification of patients who are likely to develop GTN following initial treatment for molar pregnancy [47]. A significant difference in the standardized uptake value-max (SUVmax) of pre- evacuation intrauterine molar tissue in patients who achieved normalization of hCG versus those who progressed to GTN following dilatation and curettage was observed in this single retrospective study of 11 patients [47].
Gestational Trophoblastic Disease. Doppler US can also confirm the absence of vascular flow within a mass, a useful technique in patients with GTD where clot or blood products may simulate solid tissue. CT Head If physical examination and chest radiographs are normal in a patient with GTD, metastases to other sites are unlikely, and further imaging investigation is not indicated [37,43]. CT Abdomen and Pelvis If physical examination and chest radiographs are normal in a patient with GTD, metastases to other sites are unlikely, and further imaging investigation is not indicated [37,43]. Gestational Trophoblastic Disease MRI Head If physical examination and chest radiographs are normal in a patient with GTD, metastases to other sites are unlikely, and further imaging investigation is not indicated [37,43]. MRI Pelvis To our knowledge, there is no evidence to support the routine use of MRI for initial evaluation of known or suspected GTD. Evaluation of MRI in patients with hydatidiform mole is limited to small series and cases reports [44-46]. Diffusion-weighted imaging has been evaluated as a potential predictor of subsequent GTN development in a small retrospective study and was not found to be useful [46]. FDG-PET/CT Skull Base to Mid-Thigh To our knowledge, there is no evidence to support the routine use of fluorine-18-2-fluoro-2-deoxy-D-glucose (FDG)-PET/CT for initial evaluation of known or suspected GTD. Preliminary limited data suggest a potential role for FDG-PET/CT in the identification of patients who are likely to develop GTN following initial treatment for molar pregnancy [47]. A significant difference in the standardized uptake value-max (SUVmax) of pre- evacuation intrauterine molar tissue in patients who achieved normalization of hCG versus those who progressed to GTN following dilatation and curettage was observed in this single retrospective study of 11 patients [47].