BJR female genitourinary oncology special feature: introductory editorial

Imaging, especially MRI, now plays a central role in the management of gynecological malignancies. Indeed, from tumor diagnosis and staging to response evaluation and follow-up, imaging has now been fully incorporated into the patient cancer work-up. In this BJR special feature on female genitourinary oncology, we are pleased to present a series of articles discussing some of the current hot topics, ranging from state of the art clinical practice to innovative clinically relevant research that may become more prevalent in the near future. In this collection, ovarian tumors are comprehensively discussed from tumor characterisation1 and staging2 to clinical management. The role of each imaging technique and their limitations are discussed by Lahaye et al.3 for cross-sectional imaging and Testa et al.4 for ultrasound, while Sadowski et al.1 provide insights in the O-RADS MRI classification. In this latter article, the authors emphasize the role of MRI to guide clinical management and accurately stratify patients according to their risk of malignancy. The special feature also includes a review by Addley et al.5 on serous borderline tumor which usually occurs in younger females. Young females with borderline tumors are amenable to fertility-sparing surgery regardless of FIGO stage as long as there are no invasive peritoneal implants (i.e. low-grade serous ovarian cancer). In their article, Addley et al point out the critical role of radiologist to accurately recognize this type of tumor in order to propose a correct management and avoid non-conservative surgery. In this BJR special feature, imaging of leiomyosarcomas is discussed with a special emphasis on differentiating them from the benign leiomyoma mimickers. In their article, Smith at al.6 point out the limitations of single parameter evaluation for accurate diagnosis and highlight the role of combined feature assessment to achieve the correct diagnosis proposing an interesting and practical mnemonic called “BETTER”. Meanwhile, Bura et al.7 provide a nice radiology–pathology correlation of degenerated leiomyomas linking pathology and imaging features together. Endometrial and cervical cancer staging are discussed by Pintican et al and Kido et al, respectively.8,9 Both articles highlight the importance of standardized reporting and the use of an accurate imaging protocol as proposed by the updated European Society of Urogenital radiology guidelines.10,11 Kido et al discuss the recent implementation of imaging in the new cervical cancer FIGO classification. The role of imaging in pelvic exenteration is well reviewed by Ghafoor et al.12 Moving forward to new imaging biomarkers, radiomics studies have been exponentially published in recent years. Most of them have demonstrated the potential added value of radiomics to assist/improve the radiologist accuracy in cancer detection, staging and/or response assessment. In their article, Rizzo et al.13 summarize the latest research in radiomics in endometrial and cervical cancer while Michalet et al.14 discuss the potential benefits of radiomics in the field of radiation oncology. Beer et al.15 provide insight into proteomics and its link with imaging, helping us to better understand tumor biology and tumor microenvironment. This special feature concludes with a diverse selection of original research papers. Manganaro et al.16 evaluate the role of various quantitative MRI biomarkers (diffusion-weighted imaging (DWI), intravoxel incoherent motion imaging (IVIM) and dynamic contrast enhancement MRI (DCE-MRI)) and histopathological prognostic factors in patients with endometrial cancer. Song et al.17 focus on the imaging characteristics of endometriosis-associated ovarian cancer (EAOC). They evaluate several MRI features that can help differentiate EAOC and non-EAOC. Addley et al, assess the value of non-contrast MRI features for characterisation of uterine leiomyosarcoma (LMS) and differentiation from atypical leiomyomas.18 Finally, the MRI accuracy and interobserver agreement to assess tumor response after chemoradiotherapy in locally advanced cervical carcinoma is evaluated by Jacquot et al.19 It has been our great pleasure to plan and prepare this BJR special feature on female genitourinary oncology and to work with such an amazing team of expert authors. The reviewers also deserve our sincere gratitude for providing exhaustive and critical comments within an extremely tight timeline. We hope all readers enjoy this wonderful collection of papers! Footnotes Declarations of Interest: SN, none declared. ES is a research consultant for Amazon and a Co-founder and shareholder of Lucida Medical. Contributor Information Stephanie Nougaret, Email: [email protected]. Hebert Alberto Vargas, Email: [email protected]. REFERENCES - 1.Sadowski EA, Maturen KE, Rockall A, Reinhold C, Addley H, Jha P, et al. Ovary: MRI characterisation and O-RADS MRI. Br J Radiol 2021; 94: 20210157. doi: 10.1259/bjr.20210157 [DOI] [PMC free article] [PubMed] [Google Scholar] - 2.Oliveira LRLBde, Horvat N, Andrieu PIC, Panizza PSB, Cerri GG, Viana PCC. Ovarian cancer staging: what the surgeon needs to know. Br J Radiol 2021; 94: 20210091. doi: 10.1259/bjr.20210091 [DOI] [PMC free article] [PubMed] [Google Scholar] - 3.Engbersen MP, Driel WV, Lambregts D. 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