Choriocarcinoma/Molar Pregnancy

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