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SECTION 3
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IMAGING AND THERAPY: STATE OF THE ART
By
Nandita M deSouza, Institute of Cancer Research and Royal Marsden NHS Foundation Trust,
Evis Sala, Addenbrooke’s Hospital,
Stavroula Kyriazi, Institute of Cancer Research and Royal Marsden NHS Foundation Trust,
Andrea Rockall, St Bartholomew’s Hospital
This chapter describes the range of techniques available, their relationship to tumour biology and their utility in the context of patient management pathways. In ovarian cancer, functional imaging can be particularly useful for multi-site evaluation of treatment-induced changes, although it is technically challenging because of the extent and convoluted anatomy of the peritoneal cavity. Magnetic resonance spectroscopy (MRS) has been validated sparsely in ovarian malignancy and almost exclusively for lesion characterisation. Cervical cancer shows heterogeneity relating to treatment response and to risk of metastatic spread and gene expression and their relationship to response and outcome is of interest. The presence of lymph node metastases has a detrimental effect on prognosis and a significant impact on management and treatment. The combination of DW-MRI and Magnetic resonance lymphography (MRL) is a very exciting development reported in prostate cancer, with an important reduction in the time taken for interpretation of the images.
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