الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Owing to its superior soft tissue delineation and multiplanar capability, MRI is considered the most accurate imaging modality for the evaluation of endometrial and cervical cancer, and is now an integral part of their local staging.
The limitations of morphologic imaging especially in the presence of reported pitfalls such as loss of junctional zone definition, leiomyomas, overestimation of parametrial infiltration as well as bladder and rectal invasion has urged the need for modifying the standard imaging protocol.
Potential applications of fMRI include the challenging topics of distinguishing tumor from non-tumor tissue in cervical and endometrial cancer, pre-surgical mapping, and assessment of treatment response and prediction of treatment outcome.
Our study stressed on the role of fMRI in preoperative staging aiming to emphasize its role in proper selection of patient’s management plan without increasing the expected morbidity from unnecessary procedures and accordingly increase the overall patient’s survival.
Our data suggest that DW MR imaging is more accurate in the assessment of overall FIGO staging and could replace DCE MR imaging as the potential one-stop imaging modality for endometrial cancer. The improved staging capacity of DW MR imaging may result in more accurate preoperative selection of patients for appropriate therapy.
DW-MRI was more accurate in assessment of deep myometrial invasion and parametrial infiltration and was a very sensitive and specific tool in assessing locally advanced and advanced disease. DW-MRI and DCE-MRI were equally accurate is assessing cervical stromal invasion, yet DCE-MRI was very limited in proper detection of assessment of peritoneal deposits and distant metastatic spread.
Both conventional and functional MRI by DW-MRI and DCE-MRI were defective in proper assessment of lymph node assessment and incorporation of advanced techniques such as iron oxide-enhanced MRI lymphography or single and dual-phase positron emission tomography (PET) is needed to more accurately assess nodal status of gynecological tumors.
Thus in conclusion, DW MR imaging might be a more attractive tool especially in the era of cost-efficient health care, offering the potential advantages of reduced scanning time and obviation of the intravenous administration of gadolinium-based contrast medium.
In the following chart we will try to summarize the added role of DW-MRI and DCE-MRI in pre-management staging of endometrial and cervical carcinoma