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Tarcha Z, Konstantinoff KS, Ince S, Fraum TJ, Sadowski EA, Bhosale PR, Derenoncourt PR, Zulfiqar M, Shetty AS, Ponisio MR, Mhlanga JC, Itani M. Added Value of FDG PET/MRI in Gynecologic Oncology: A Pictorial Review. Radiographics 2023; 43:e230006. [PMID: 37410624 DOI: 10.1148/rg.230006] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
Fluorine 18-fluorodeoxyglucose (FDG) PET and MRI independently play a valuable role in the management of patients with gynecologic malignancies, particularly endometrial and cervical cancer. The PET/MRI hybrid imaging technique combines the metabolic information obtained from PET with the excellent soft-tissue resolution and anatomic details provided by MRI in a single examination. MRI is the modality of choice for assessment of local tumor extent in the pelvis, whereas PET is used to assess for local-regional spread and distant metastases. The authors discuss the added value of FDG PET/MRI in imaging gynecologic malignancies of the pelvis, with a focus on the role of FDG PET/MRI in diagnosis, staging, assessing treatment response, and characterizing complications. PET/MRI allows better localization and demarcation of the extent of disease, characterization of lesions and involvement of adjacent organs and lymph nodes, and improved differentiation of benign from malignant tissues, as well as detection of the presence of distant metastasis. It also has the advantages of decreased radiation dose and a higher signal-to-noise ratio of a prolonged PET examination of the pelvis contemporaneous with MRI. The authors provide a brief technical overview of PET/MRI, highlight how simultaneously performed PET/MRI can improve stand-alone MRI and PET/CT in gynecologic malignancies, provide an image-rich review to illustrate practical and clinically relevant applications of this imaging technique, and review common pitfalls encountered in clinical practice. ©RSNA, 2023 Quiz questions for this article are available in the supplemental material.
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Affiliation(s)
- Ziad Tarcha
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, St. Louis, MO, 63110-8131 (Z.T., K.S.K., S.I., T.J.F., P.R.D., A.S.S., M.R.P., J.C.M., M.I.); Department of Radiology, Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, Wis (E.A.S.); Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Tex (P.R.B.); and Department of Radiology, Mayo Clinic, Scottsdale, Ariz (M.Z.)
| | - Katerina S Konstantinoff
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, St. Louis, MO, 63110-8131 (Z.T., K.S.K., S.I., T.J.F., P.R.D., A.S.S., M.R.P., J.C.M., M.I.); Department of Radiology, Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, Wis (E.A.S.); Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Tex (P.R.B.); and Department of Radiology, Mayo Clinic, Scottsdale, Ariz (M.Z.)
| | - Semra Ince
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, St. Louis, MO, 63110-8131 (Z.T., K.S.K., S.I., T.J.F., P.R.D., A.S.S., M.R.P., J.C.M., M.I.); Department of Radiology, Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, Wis (E.A.S.); Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Tex (P.R.B.); and Department of Radiology, Mayo Clinic, Scottsdale, Ariz (M.Z.)
| | - Tyler J Fraum
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, St. Louis, MO, 63110-8131 (Z.T., K.S.K., S.I., T.J.F., P.R.D., A.S.S., M.R.P., J.C.M., M.I.); Department of Radiology, Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, Wis (E.A.S.); Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Tex (P.R.B.); and Department of Radiology, Mayo Clinic, Scottsdale, Ariz (M.Z.)
| | - Elizabeth A Sadowski
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, St. Louis, MO, 63110-8131 (Z.T., K.S.K., S.I., T.J.F., P.R.D., A.S.S., M.R.P., J.C.M., M.I.); Department of Radiology, Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, Wis (E.A.S.); Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Tex (P.R.B.); and Department of Radiology, Mayo Clinic, Scottsdale, Ariz (M.Z.)
| | - Priya R Bhosale
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, St. Louis, MO, 63110-8131 (Z.T., K.S.K., S.I., T.J.F., P.R.D., A.S.S., M.R.P., J.C.M., M.I.); Department of Radiology, Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, Wis (E.A.S.); Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Tex (P.R.B.); and Department of Radiology, Mayo Clinic, Scottsdale, Ariz (M.Z.)
| | - Paul-Robert Derenoncourt
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, St. Louis, MO, 63110-8131 (Z.T., K.S.K., S.I., T.J.F., P.R.D., A.S.S., M.R.P., J.C.M., M.I.); Department of Radiology, Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, Wis (E.A.S.); Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Tex (P.R.B.); and Department of Radiology, Mayo Clinic, Scottsdale, Ariz (M.Z.)
| | - Maria Zulfiqar
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, St. Louis, MO, 63110-8131 (Z.T., K.S.K., S.I., T.J.F., P.R.D., A.S.S., M.R.P., J.C.M., M.I.); Department of Radiology, Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, Wis (E.A.S.); Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Tex (P.R.B.); and Department of Radiology, Mayo Clinic, Scottsdale, Ariz (M.Z.)
| | - Anup S Shetty
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, St. Louis, MO, 63110-8131 (Z.T., K.S.K., S.I., T.J.F., P.R.D., A.S.S., M.R.P., J.C.M., M.I.); Department of Radiology, Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, Wis (E.A.S.); Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Tex (P.R.B.); and Department of Radiology, Mayo Clinic, Scottsdale, Ariz (M.Z.)
| | - Maria R Ponisio
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, St. Louis, MO, 63110-8131 (Z.T., K.S.K., S.I., T.J.F., P.R.D., A.S.S., M.R.P., J.C.M., M.I.); Department of Radiology, Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, Wis (E.A.S.); Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Tex (P.R.B.); and Department of Radiology, Mayo Clinic, Scottsdale, Ariz (M.Z.)
| | - Joyce C Mhlanga
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, St. Louis, MO, 63110-8131 (Z.T., K.S.K., S.I., T.J.F., P.R.D., A.S.S., M.R.P., J.C.M., M.I.); Department of Radiology, Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, Wis (E.A.S.); Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Tex (P.R.B.); and Department of Radiology, Mayo Clinic, Scottsdale, Ariz (M.Z.)
| | - Malak Itani
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, St. Louis, MO, 63110-8131 (Z.T., K.S.K., S.I., T.J.F., P.R.D., A.S.S., M.R.P., J.C.M., M.I.); Department of Radiology, Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, Wis (E.A.S.); Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Tex (P.R.B.); and Department of Radiology, Mayo Clinic, Scottsdale, Ariz (M.Z.)
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Virarkar M, Vulasala SS, Daoud T, Javadi S, Lall C, Bhosale P. Vulvar Cancer: 2021 Revised FIGO Staging System and the Role of Imaging. Cancers (Basel) 2022; 14:2264. [PMID: 35565394 PMCID: PMC9102312 DOI: 10.3390/cancers14092264] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 04/28/2022] [Accepted: 04/29/2022] [Indexed: 01/27/2023] Open
Abstract
Vulvar cancer is a rare gynecological malignancy. It constitutes 5-8% of all gynecologic neoplasms, and squamous cell carcinoma is the most common variant. This article aims to review the etiopathogenesis revised 2021 International Federation of Gynecology and Obstetrics (FIGO) classification and emphasize imaging in the staging of vulvar cancer. The staging has been regulated by FIGO since 1969 and is subjected to multiple revisions. Previous 2009 FIGO classification is limited by the prognostic capability, which prompted the 2021 revisions and issue of a new FIGO classification. Although vulvar cancer can be visualized clinically, imaging plays a crucial role in the staging of the tumor, assessing the tumor extent, and planning the management. In addition, sentinel lymph node biopsy facilitates the histopathological staging of the draining lymph node, thus enabling early detection of tumor metastases and better survival rates.
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Affiliation(s)
- Mayur Virarkar
- Department of Diagnostic Radiology, University of Florida College of Medicine, 655 West 8th Street, C90, 2nd Floor, Clinical Center, Jacksonville, FL 32209, USA; (M.V.); (C.L.)
| | - Sai Swarupa Vulasala
- Department of Diagnostic Radiology, University of Florida College of Medicine, 655 West 8th Street, C90, 2nd Floor, Clinical Center, Jacksonville, FL 32209, USA; (M.V.); (C.L.)
| | - Taher Daoud
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA; (T.D.); (S.J.); (P.B.)
| | - Sanaz Javadi
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA; (T.D.); (S.J.); (P.B.)
| | - Chandana Lall
- Department of Diagnostic Radiology, University of Florida College of Medicine, 655 West 8th Street, C90, 2nd Floor, Clinical Center, Jacksonville, FL 32209, USA; (M.V.); (C.L.)
| | - Priya Bhosale
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA; (T.D.); (S.J.); (P.B.)
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Nikolić O, Sousa FAE, Cunha TM, Nikolić MB, Otero-García MM, Gui B, Nougaret S, Leonhardt H. Vulvar cancer staging: guidelines of the European Society of Urogenital Radiology (ESUR). Insights Imaging 2021; 12:131. [PMID: 34550489 PMCID: PMC8458511 DOI: 10.1186/s13244-021-01075-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 08/11/2021] [Indexed: 12/02/2022] Open
Abstract
Objective The aim of the Female Pelvic Imaging Working Group of the European Society of Urogenital Radiology (ESUR) was to develop imaging staging guidelines for vulvar cancer and to propose standardised MRI protocols and reporting. Methods The guidelines recommended from the ESUR in this article resulted from a questionnaire analysis regarding imaging staging of vulvar cancer that was answered by all members of the Female Pelvic Imaging Working Group. Only the answers with an agreement equal to or more than 80% were considered. Additionally, the literature was reviewed to complement and further support our conclusions. Results The critical review of the literature and consensus obtained among experts allows for recommendations regarding imaging staging guidelines, patient preparation, MRI protocol, and a structured MRI report. Conclusions Standardising image acquisition techniques and MRI interpretation reduces ambiguity and ultimately improves the contribution of radiology to the staging and management of patients with vulvar cancer. Moreover, structured reporting assists with the communication of clinically relevant information to the referring physician.
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Affiliation(s)
- Olivera Nikolić
- Center of Radiology, Clinical Center of Vojvodina, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 1-9, 21000, Novi Sad, Serbia
| | - Filipa Alves E Sousa
- Department of Radiology, Centro Hospitalar Universitário de Lisboa Central, Alameda Santo António Dos Capuchos, 1169-050, Lisboa, Portugal.
| | - Teresa Margarida Cunha
- Department of Radiology, Instituto Português de Oncologia de Lisboa Francisco Gentil, R. Prof. Lima Basto, 1099-023, Lisbon, Portugal
| | - Marijana Basta Nikolić
- Center of Radiology, Clinical Center of Vojvodina, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 1-9, 21000, Novi Sad, Serbia
| | | | - Benedetta Gui
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Radiologia Generale Ed Interventistica Generale, Area Diagnostica Per Immagini, Dipartimento Diagnostica Per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy
| | - Stephanie Nougaret
- Department of Radiology, Montpellier Cancer Institute, 15 INSERM, Montpellier Cancer Research Institute, U1194, University of Montpellier, 208 Avenue des Apothicaires, 34295, Montpellier, France
| | - Henrik Leonhardt
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska University Hospital, Bruna straket 11B, 413 45, Gothenburg, Sweden
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7
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Garganese G, Fragomeni SM, Pasciuto T, Leombroni M, Moro F, Evangelista MT, Bove S, Gentileschi S, Tagliaferri L, Paris I, Inzani F, Fanfani F, Scambia G, Testa AC. Ultrasound morphometric and cytologic preoperative assessment of inguinal lymph-node status in women with vulvar cancer: MorphoNode study. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2020; 55:401-410. [PMID: 31237047 DOI: 10.1002/uog.20378] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 06/11/2019] [Accepted: 06/17/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To assess the accuracy of preoperative ultrasound examination for predicting lymph-node (LN) status in patients with vulvar cancer. METHODS This was a single-institution retrospective observational study of all women with a histological diagnosis of vulvar cancer triaged to inguinal surgery within 30 days following ultrasound evaluation between December 2010 and January 2016. For each groin examined, 15 morphological and dimensional sonographic parameters associated with suspicion for LN involvement were examined. A morphometric ultrasound pattern (MUP) was expressed for each groin, classifying the inguinal LN status into five groups (normal; reactive-but-negative; minimally suspicious/probably negative; moderately suspicious; and highly suspicious/positive) according to subjective judgment, followed by stratification as positive or negative for metastasis according to morphometric binomial assessment (MBA). In cases of positive MBA, fine-needle aspiration cytology was performed. Combining the information obtained from MUP and cytologic results, a binomial final overall assessment (FOA) was assigned for each groin. The final histology was considered as the reference standard. Comparison was performed between patients with negative and those with positive LNs on histology, and receiver-operating-characteristics curves were generated for statistically significant variables on univariate analysis, to evaluate their diagnostic ability to predict negative LN status. RESULTS Of 144 patients included in the analysis, 87 had negative inguinal LNs and 57 had positive LNs on histology. A total of 256 groins were analyzed, of which 171 were negative and 85 showed at least one metastatic LN on histology. The following parameters showed the greatest accuracy, with the best balance between specificity and sensitivity, in predicting negative LN status: cortical (C) thickness of the dominant LN (cut-off, 2.5 mm; sensitivity, 90.0%; specificity, 77.9%); short-axis (S) length of the dominant LN (cut-off, 8.4 mm; sensitivity, 63.9%; specificity, 90.6%); C/medulla (M) thickness ratio of the dominant LN (cut-off, 1.2 mm; sensitivity, 70.4%; specificity, 91.5%), the combination of S length and C/M thickness ratio (sensitivity, 88.9%; specificity, 82.4%); and the FOA analysis (sensitivity, 85.9%; specificity, 84.2%). CONCLUSIONS Preoperative ultrasound assessment, with or without the addition of cytology, has a high accuracy in assessing inguinal LN status in patients with vulvar cancer. In particular, the combination of two ultrasound parameters (S length and C/M thickness ratio) provided the greatest accuracy in discriminating between negative and positive LNs. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- G Garganese
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- Gynecology and Breast Care Center, Mater Olbia Hospital, Olbia, Italy
| | - S M Fragomeni
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Unità di Ginecologia Oncologica, Rome, Italy
| | - T Pasciuto
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, STAR Center (Statistics Technology Archiving Research Center), Rome, Italy
| | - M Leombroni
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Unità di Ginecologia Oncologica, Rome, Italy
| | - F Moro
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Unità di Ginecologia Oncologica, Rome, Italy
| | - M T Evangelista
- Ginecologia Oncologica, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - S Bove
- Gynecology and Breast Care Center, Mater Olbia Hospital, Olbia, Italy
| | - S Gentileschi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Unità di Chirurgia Plastica, Rome, Italy
- Istituto di Clinica Chirurgica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - L Tagliaferri
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC di Radioterapia, Dipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, Rome, Italy
| | - I Paris
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Unità di Ginecologia Oncologica, Rome, Italy
| | - F Inzani
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Unità di Gineco-patologia e Patologia Mammaria, Rome, Italy
| | - F Fanfani
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Unità di Ginecologia Oncologica, Rome, Italy
- Istituto di Clinica Ostetrica e Ginecologica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Scambia
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Unità di Ginecologia Oncologica, Rome, Italy
- Istituto di Clinica Ostetrica e Ginecologica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A C Testa
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Unità di Ginecologia Oncologica, Rome, Italy
- Istituto di Clinica Ostetrica e Ginecologica, Università Cattolica del Sacro Cuore, Rome, Italy
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Ssi-Yan-Kai G, Thubert T, Rivain AL, Prevot S, Deffieux X, De Laveaucoupet J. Female perineal diseases: spectrum of imaging findings. ACTA ACUST UNITED AC 2016; 40:2690-709. [PMID: 25896612 DOI: 10.1007/s00261-015-0427-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The female perineum, which is divided into the anterior urogenital triangle and the posterior anal triangle, is a surface structure often overlooked. Female perineal diseases may present with nonspecific clinical signs due to its close anatomical relationship between the different compartments. Diagnosis of the origin of a perineal disorder may also be a difficult problem encountered in pelvi-perineal imaging. Therefore, a precise knowledge of the female perineal anatomy and the associated disease processes is essential to radiologists, pathologists, and surgeons alike who are involved in the evaluation of the patient who presents with a perineal mass. Cross-sectional imaging plays a crucial role for proper management. Due to the robust contrast resolution of MR, MR imaging is the modality of choice for evaluation of the extent of a complex perineal lesion, its relationship to the adjacent structures. It has a greater sensitivity and specificity for the diagnosis than the other non-invasive imaging techniques and is helpful in guidance for surgical planning. The purpose of this article is to highlight the spectrum of imaging findings of female perineal diseases.
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Affiliation(s)
- Guillaume Ssi-Yan-Kai
- Service de Radiologie, AP-HP, Hôpital Antoine Béclère, 157 rue de la porte de Trivaux, 92140, Clamart, France.
| | - Thibault Thubert
- Service de Gynécologie-Obstétrique, AP-HP, Hôpital Antoine Béclère, 157 rue de la porte de Trivaux, 92140, Clamart, France
| | - Anne-Laure Rivain
- Service de Gynécologie-Obstétrique, AP-HP, Hôpital Antoine Béclère, 157 rue de la porte de Trivaux, 92140, Clamart, France
| | - Sophie Prevot
- Service d'Anatomie-Pathologie, AP-HP, Hôpital Antoine Béclère, 157 rue de la porte de Trivaux, 92140, Clamart, France
| | - Xavier Deffieux
- Service de Gynécologie-Obstétrique, AP-HP, Hôpital Antoine Béclère, 157 rue de la porte de Trivaux, 92140, Clamart, France
| | - Jocelyne De Laveaucoupet
- Service de Radiologie, AP-HP, Hôpital Antoine Béclère, 157 rue de la porte de Trivaux, 92140, Clamart, France
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