2023 ARRS ANNUAL MEETING - ABSTRACTS

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E2407. Imaging of the Posttreatment Pelvis With Gynecological Cancer
Authors
  1. Hagar Mahmoud; Yale New Haven Health/Bridgeport Hospital
  2. Namita bhagat; Yale New Haven Health/Bridgeport Hospital
  3. Apurva Bonde; UT Health San Antonio
  4. Juan Ibarra Rovira; MD Anderson Cancer Center
  5. Silvana Faria; MD Anderson Cancer Center
  6. Noel velasco; Yale New Haven Health/Bridgeport Hospital
  7. Priya bhosale; MD Anderson Cancer Center
Background
Gynecologic malignancies reports for 10% - 15% of all malignancies in women. Gynecologic cancers are usually managed with surgery, chemotherapy, or radiation therapy. Posttreatment imaging take a critical role in the assessment of treatment response and tumor recurrence/residual. Imaging of the female pelvis after chemotherapy and radiation therapy is very challenging due to changes that occur to normal anatomy and loss of tissue and fat planes.Some of these changes and complications are ,for example fistulas, proctitis, enteritis, typhlitis, cystitis, and insufficiency fractures. Radiologists should be aware of both the expected posttreatment imaging features and the imaging findings of common complications for better interpretation and avoid potential pitfalls.

Educational Goals / Teaching Points
Interpretation of the posttreatment appearances of the female pelvis. Understanding of the imaging findings commonly seen after different treatment options as surgery, chemotherapy and radiation therapy. Acquaintance of the common posttreatment complications. Avoiding possible pitfalls. Differentiation of common complications imaging features from recurrent tumor.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Review of imaging features of post treatment pelvis with different imaging modalities as ultrasound, CT and MRI. Variety of oncologic options for treatment of gynecological cancers. Review of the imaging features of the post treatment gastrointestinal complications as bowel perforation, enteritis, colitis, typhlitis and proctitis. Review of the imaging features of the post-treatment genitourinary complication as fistulas, strictures cystitis and hydroureteronephrosis. Review of the imaging features of the post treatment other abdominal/musculoskeletal complications such as soft tissue swelling/edema, abscess, lymphocele and insufficiency fractures.

Conclusion
Interpretation of the posttreatment appearances of the female pelvis might be challenging, and some complications can look like malignant disease and vice versa. For correct assessment, understanding of the features usually seen after chemotherapy and radiation therapy plays a crucial role in making the correct interpretation and avoiding pitfalls. Radiologist should be acquainted with imaging findings long-term posttreatment appearances of the pelvis as well as the immediate changes and complications, including the affected and should be able to differentiate those form the recurrent /residual tumor.