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World J Radiol. Mar 28, 2016; 8(3): 288-297
Published online Mar 28, 2016. doi: 10.4329/wjr.v8.i3.288
Diffusion weighted imaging in gynecological malignancies - present and future
Dinesh Manoharan, Chandan J Das, Ankita Aggarwal, Arun K Gupta
Dinesh Manoharan, Chandan J Das, Ankita Aggarwal, Arun K Gupta, Department of Radiology Diagnosis, All India Institute of Medical Science, New Delhi 110029, Delhi, India
Author contributions: Manoharan D and Das CJ contributed equally to conception, article design, literature search, article drafting, critical revision and image preparation; Aggarwal A helped with the article concept and revision; Gupta AK helped in article preparation and final approval of version of article to be published.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Chandan J Das, MD, DNB, MNAMS, Assistant Professor, Department of Radiology Diagnosis, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, Delhi, India. docchandan17@gmail.com
Telephone: +91-11-26594889 Fax: +91-11-26588663
Received: May 24, 2015
Peer-review started: May 25, 2015
First decision: September 23, 2015
Revised: October 31, 2015
Accepted: December 3, 2015
Article in press: December 4, 2015
Published online: March 28, 2016
Processing time: 302 Days and 7.1 Hours
Abstract

The management of gynaecological malignancies has undergone a significant change in recent years with our improved understanding of cancer biogenetics, development of new treatment regimens and enhanced screening. Due to the rapid blooming of newer methods and techniques in gynaecology, surgery and oncology the scope and the role of imaging has also widened. Functional imaging in the form of diffusion weighted imaging (DWI) has been recently found to be very useful in assessing various tumours. Its ability to identify changes in the molecular level has dramatically changed the diagnostic approach of radiologists which was solely based on morphological criteria. It can improve the diagnostic accuracy of conventional magnetic resonance imaging, lend a hand in assessing tumour response to treatment regimens and detect tumour recurrence with better spatial resolution, negative radiation and diagnostic accuracy compared to positron emission tomography scan. The ability to quantify the diffusion has also lead to potential prediction of tumour aggressiveness and grade which directly correlate with the patient prognosis and management. Hence, it has become imperative for a radiologist to understand the concepts of DWI and its present and evolving role. In this article we present a brief description of the basics of DWI followed by its role in evaluation of female gynaecological malignancies.

Keywords: Diffusion weighted imaging; Female pelvis; Magnetic resonance imaging; Gynaecology; Malignancy

Core tip: With rapidly evolving strategies in the management of the gynaecological malignancies today there is an increasing role of imaging to keep up with the pace of development and develop newer techniques which help in better management of the patient. Diffusion weighted imaging (DWI) is one such modality which helps in detecting changes at the molecular level and hence can help in better diagnosis of early cancers as well as in assessing response to treatment. The purpose of this article is to make the reader familiar with the basic concepts of DWI and discuss the latest development in this field in evaluation of female gynaecological malignancies.