Adenomyosis at a Glance: An Integrated Review of Transvaginal Ultrasound and MR Imaging Findings.

Adenomyosis is a benign uterine disorder increasingly recognized in premenopausal women. Given its significant clinical burden, an accurate noninvasive diagnosis is paramount. Both transvaginal ultrasound (TVUS) and magnetic resonance (MR) provide an adequate assessment of adenomyosis, the former being recommended for first-line imaging evaluation and the latter being mainly used as a problem-solving technique. In this article, the authors review the TVUS and MR imaging findings of adenomyosis while referring to their histopathological background. Whereas direct signs correlate directly to ectopic endometrial tissue and are highly specific to adenomyosis, indirect signs result from myometrial hypertrophy and increase diagnostic sensitivity. Potential pitfalls, differential diagnoses, and frequently associated estrogen-dependent conditions are also discussed.

MRI in the Evaluation of Locally Advanced Vulvar Cancer Treated with Chemoradiotherapy and Vulvar Cancer Recurrence: The 2021 Revision of FIGO Classification and the Need for Multidisciplinary Management.

Magnetic resonance imaging (MRI) plays an essential role in the management of patients with locally advanced vulvar cancer (LAVC), who frequently benefit from a multidisciplinary approach. Accordingly, chemoradiotherapy (CRT) with radical or neoadjuvant intent seems to provide a better quality of life and less morbidity than extensive surgery alone. In this overview, we discuss the role of MRI in the post-CRT assessment of LAVC, emphasizing the evaluation of primary tumor response. In order to assess treatment response and select candidates for post-CRT local excision, the MRI findings are described according to signal intensity, restricted diffusion, enhancement, and invasion of adjacent organs. We also focus on the role of MRI in detecting vulvar cancer recurrence. It occurs in 30-50% of patients within two years after initial treatment, the majority appearing near the original resection margins or in ipsilateral inguinal or pelvic lymph nodes. Finally, we describe early and delayed complications of CRT, such as cellulitis, urethritis, vulvar edema, bone changes, myositis, and fistulization. By describing the role of MRI in assessing LAVC response to CRT and detecting recurrence, we hope to provide suitable indications for a personalized approach.

Imaging evaluation of the liver in oncology patients: A comparison of techniques.

The liver is commonly affected by metastatic disease. Therefore, it is essential to detect and characterize liver metastases, assuming that patient management and prognosis rely on it. The imaging techniques that allow non-invasive assessment of liver metastases include ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET)/CT, and PET/MRI. In this paper, we review the imaging findings of liver metastases, focusing on each imaging modality's advantages and potential limitations. We also assess the importance of different imaging modalities for the management, follow-up, and therapy response of liver metastases. To date, both CT and MRI are the most appropriate imaging methods for initial lesion detection, follow-up, and assessment of treatment response. Multiparametric MRI is frequently used as a problem-solving technique for liver lesions and has evolved substantially over the past decade, including hardware and software developments and specific intravenous contrast agents. Several studies have shown that MRI performs better in small-sized metastases and moderate to severe liver steatosis cases. Although state-of-the-art MRI shows a greater sensitivity for detecting and characterizing liver metastases, CT remains the chosen method. We also present the controversial subject of the "economic implication" to use CT over MRI.