Preliminary Diagnosis: Choriocarcinoma/Molar Preganancy

I. What imaging technique is first-line for this diagnosis?

  • Ultrasound with Doppler interrogation

II. Describe the advantages and disadvantages of this technique for diagnosis of choriocarcinoma/molar pregnancy.

Advantages

  • Quick

  • Inexpensive

  • Fairly specific and sensitive

  • Requires no ionizing radiation

Disadvantages

  • Difficult to assess for extrauterine and extrapelvic metastases

  • Not as specific as MRI

III. What are the contraindications for the first-line imaging technique?

No contraindications

IV. What alternative imaging techniques are available?

  • MRI with and without contrast

  • CT of the abdomen and pelvis with and without contrast

V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of choriocarcinoma/molar pregnancy.

MRI with and without contrast
Advantages

  • Better demonstrates the boundaries of myometrium and tumor than does CT

  • Requires no ionizing radiation

Disadvantages

  • Expensive

  • Time consuming

  • Requires significant patient cooperation to minimize motion artifact

CT of the abdomen and pelvis with and without contrast
Advantages

  • Sensitive and specific for diagnosis

  • Quick

  • Less expensive than MRI

Disadvantages

  • Exposure to ionizing radiation

  • Exposure to iodinated contrast

VI. What are the contraindications for the alternative imaging techniques?

MRI with and without contrast

Absolute contraindication is non-MR-compatible hardware.

CT of the abdomen and pelvis with and without contrast

Relative contraindication during pregnancy

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