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Abdominal Radiology
Published in: Abdominal Radiology 5/2023

10-02-2023 | Magnetic Resonance Imaging | Special Section : Cancer in Pregnancy

Gestational trophoblastic disease: an update

Authors: Tanya Chawla, Genevieve Bouchard-Fortier, Gulisa Turashvili, Ray Osborne, Kalesha Hack, Phyllis Glanc

Published in: Abdominal Radiology | Issue 5/2023

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Abstract

Gestational trophoblastic diseases (GTD) encompass a spectrum of rare pre-malignant and malignant entities originating from trophoblastic tissue. This updated review will highlight important radiological features, pathology and classification, and provide insight into the clinical management of these uncommon disorders. There is a wide geographic variation with the incidence of hydatidiform mole varying between 0.57 and 2 per 1000 pregnancies. The use of ultrasound (US) in the management of early pregnancy symptoms and complications has positively impacted the earlier detection of these diseases and resulted in diminished morbidity. Additional imaging modalities are reserved for problem solving or assessment of pulmonary manifestations of molar pregnancy. Having an awareness of their pleomorphic sonographic presentation and additional pathology that can mimic GTD is critical to avoiding pitfalls. Histologic and molecular analysis further aids in differential diagnosis. Gestational trophoblastic neoplasia (GTN) is inclusive of all malignant GTDs, and arises after 20% of molar pregnancies but can also be seen with non-molar gestations. Biochemical monitoring with human chorionic gonadotrophin is imperative for ongoing monitoring and surveillance and allows early detection of this entity. Doppler US is used for confirmation of diagnosis with magnetic resonance imaging (MRI) reserved for problem solving or assessment of myometrial invasion. This is of heightened relevance in patients undergoing surgical management. Cross sectional imaging is reserved for patients in the setting of GTN for the purposes of staging, prognostication and in the setting of recurrent disease. This may require a combination of computed tomography, MRI and positron emission tomography. Doppler US can provide insight into chemotherapeutic response/predict resistance in patients with GTN. As our understanding of these disorders evolves, there has been maturation in management options with a shift from traditional chemotherapy to innovative immunotherapy, particularly in the setting of resistant or high-risk disease.
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Literature
1.
Jin-Lin Hou 1, Xi-Run Wan, Yang Xiang, Qing-Wei Qi, Xiu-Yu Yang. Changes of clinical features in hydatidiform mole: analysis of 113 cases. J Reprod Med. 2008;53(8):629–33.
2.
V Soto-Wright 1, M Bernstein, D P Goldstein, R S Berkowitz. The changing clinical presentation of complete molar pregnancy. Obstet Gynecol. 1995;86(5):775–9.
3.
Sue Yazaki Sun 1, Alexander Melamed 2, Donald P Goldstein 2, Marilyn R Bernstein 2, Neil S Horowitz 2, Antonio Fernandes Moron 1, Izildinha Maestá 3, Antonio Braga 4, Ross S Berkowitz 5. Changing presentation of complete hydatidiform mole at the New England Trophoblastic Disease Center over the past three decades: does early diagnosis alter risk for gestational trophoblastic neoplasia? Gynecol Oncol. 2015;138(1):46–9.
4.
Ngan HYS, Seckl MJ, Berkowitz RS, Xiang Y, Golfier F, Sekharan PK, et al. Diagnosis and management of gestational trophoblastic disease: 2021 update. Int J Gynecol Obstet. 2021;155(S1):86–93.CrossRef
5.
Zalel Y, Dgani R. Gestational trophoblastic disease following the evacuation of partial hydatidiform mole: a review of 66 cases. Eur J Obstet Gynecol Reprod Biol. 1997;71(1):67–71.PubMedCrossRef
6.
Jacobs PA, Szulman AE, Funkhouser J, Matsuura JS, Wilson CC. Human triploidy: relationship between parental origin of the additional haploid complement and development of partial hydatidiform mole. Ann Hum Genet. 1982;46(3):223–31.PubMedCrossRef
7.
Hui P, Buza N, Murphy KM, Ronnett BM. Hydatidiform Moles: Genetic Basis and Precision Diagnosis. Annu Rev Pathol Mech Dis. 2017;12(1):449–85.CrossRef
8.
Sebire NJ, Fisher RA, Rees HC. Histopathological Diagnosis of Partial and Complete Hydatidiform Mole in the First Trimester of Pregnancy. Pediatr Dev Pathol. 2003;6(1):69–77.PubMedCrossRef
9.
Buza N, Hui P. Partial Hydatidiform Mole: Histologic Parameters in Correlation with DNA Genotyping. Int J Gynecol Pathol. 2013;32(3):307–15.PubMedCrossRef
10.
Fisher RA, Tommasi A, Short D, Kaur B, Seckl MJ, Sebire NJ. Clinical utility of selective molecular genotyping for diagnosis of partial hydatidiform mole; a retrospective study from a regional trophoblastic disease unit. J Clin Pathol. 2014;67(11):980–4.PubMedCrossRef
11.
Sumigama S, Itakura A, Yamamoto T, Nagasaka T, Yamamoto E, Ino K, et al. Genetically Identified Complete Hydatidiform Mole Coexisting with a Live Twin Fetus: Comparison with Conventional Diagnosis. Gynecol Obstet Invest. 2007;64(4):228–31.PubMedCrossRef
12.
Ronnett BM. Hydatidiform Moles: Ancillary Techniques to Refine Diagnosis. Arch Pathol Lab Med. 2018 Dec 1;142(12):1485–502.PubMedCrossRef
13.
Buza N, Hui P. Immunohistochemistry and other ancillary techniques in the diagnosis of gestational trophoblastic diseases. Semin Diagn Pathol. 2014;31(3):223–32.PubMedCrossRef
14.
Banet N, DeScipio C, Murphy KM, Beierl K, Adams E, Vang R, et al. Characteristics of hydatidiform moles: analysis of a prospective series with p57 immunohistochemistry and molecular genotyping. Mod Pathol. 2014;27(2):238–54.PubMedCrossRef
15.
Bynum J, Murphy KM, DeScipio C, Beierl K, Adams E, Anderson D, et al. Invasive Complete Hydatidiform Moles: Analysis of a Case Series with Genotyping. Int J Gynecol Pathol. 2016;35(2):134–41.PubMedCrossRef
16.
Fukunaga M. Immunohistochemical characterization of p57(KIP2) expression in early hydatidiform moles. Hum Pathol. 2002;33(12):1188–92.PubMedCrossRef
17.
Allen SD, Lim AK, Seckl MJ, Blunt DM, Mitchell AW. Radiology of gestational trophoblastic neoplasia. Clin Radiol. 2006;61(4):301–13.PubMedCrossRef
18.
Fine C, Bundy AL, Berkowitz RS, Boswell SB, Berezin AF, Doubilet PM. Sonographic diagnosis of partial hydatidiform mole. Obstet Gynecol. 1989 Mar;73(3 Pt 1):414–8.PubMed
19.
Kirk E, Papageorghiou AT, Condous G, Bottomley C, Bourne T. The accuracy of first trimester ultrasound in the diagnosis of hydatidiform mole. Ultrasound Obstet Gynecol. 2007;29(1):70–5.PubMedCrossRef
20.
Fowler DJ, Lindsay I, Seckl MJ, Sebire NJ. Routine pre‐evacuation ultrasound diagnosis of hydatidiform mole: experience of more than 1000 cases from a regional referral center. Ultrasound Obstet Gynecol. 2006;27(1):56–60.PubMedCrossRef
21.
Newhouse I, Spacey A, Scragg B, Szczepura K. The diagnostic value and accuracy of ultrasound in diagnosing hydatidiform mole: A systematic review and meta-analysis of the literature. Radiography. 2022;28(4):897–905.PubMedCrossRef
22.
Jauniaux E, Memtsa M, Johns J, Ross JA, Jurkovic D. New insights in the pathophysiology of complete hydatidiform mole. Placenta. 2018; 62:28–33.PubMedCrossRef
23.
24.
Zhou Q, Lei XY, Xie Q, Cardoza JD. Sonographic and Doppler Imaging in the Diagnosis and Treatment of Gestational Trophoblastic Disease: A 12-Year Experience. J Ultrasound Med. 2005;24(1):15–24.PubMedCrossRef
25.
Lin LH, Bernardes LS, Hase EA, Fushida K, Francisco RPV. Is Doppler ultrasound useful for evaluating gestational trophoblastic disease? Clin Sao Paulo Braz. 2015;70(12):810–5.CrossRef
26.
Agarwal R, Strickland S, McNeish IA, Patel DC, Foskett M, Boultbee JE, et al. Doppler ultrasonography of the uterine artery and the response to chemotherapy in patients with gestational trophoblastic tumors. Clin Cancer Res Off J Am Assoc Cancer Res. 2002;8(5):1142–7.
27.
Hricak H, Demas BE, Braga CA, Fisher MR, Winkler ML. Gestational trophoblastic neoplasm of the uterus: MR assessment. Radiology. 1986;161(1):11–6.PubMedCrossRef
28.
Hancock BW, Nazir K, Everard JE. Persistent gestational trophoblastic neoplasia after partial hydatidiform mole incidence and outcome. J Reprod Med. 2006;51(10):764–6.PubMed
29.
Wolfberg AJ, Berkowitz RS, Goldstein DP, Feltmate C, Lieberman E. Postevacuation hCG Levels and Risk of Gestational Trophoblastic Neoplasia in Women with Complete Molar Pregnancy: Obstet Gynecol. 2005;106(3):548–52.PubMed
30.
Seckl MJ, Fisher RA, Salerno G, Rees H, Paradinas FJ, Foskett M, et al. Choriocarcinoma and partial hydatidiform moles. The Lancet. 2000;356(9223):36–9.CrossRef
31.
Eiriksson L, Dean E, Sebastianelli A, Salvador S, Comeau R, Jang JH, et al. Guideline No. 408: Management of Gestational Trophoblastic Diseases. J Obstet Gynaecol Can. 2021;43(1):91–105.e1.
32.
Sebire N, Foskett M, Short D, Savage P, Stewart W, Thomson M, et al. Shortened duration of human chorionic gonadotrophin surveillance following complete or partial hydatidiform mole: evidence for revised protocol of a UK regional trophoblastic disease unit. BJOG Int J Obstet Gynaecol. 2007;114(6):760–2.CrossRef
33.
Schmitt C, Doret M, Massardier J, Hajri T, Schott AM, Raudrant D, et al. Risk of gestational trophoblastic neoplasia after hCG normalisation according to hydatidiform mole type. Gynecol Oncol. 2013;130(1):86–9.PubMedCrossRef
34.
Coyle C, Short D, Jackson L, Sebire NJ, Kaur B, Harvey R, et al. What is the optimal duration of human chorionic gonadotrophin surveillance following evacuation of a molar pregnancy? A retrospective analysis on over 20,000 consecutive patients. Gynecol Oncol. 2018;148(2):254–7.PubMedCrossRef
35.
Sebire NJ, Fisher RA, Foskett M, Rees H, Seckl MJ, Newlands ES. Risk of recurrent hydatidiform mole and subsequent pregnancy outcome following complete or partial hydatidiform molar pregnancy. BJOG Int J Obstet Gynaecol. 2003;110(1):22–6.CrossRef
36.
Rice LW, Lage JM, Berkowitz RS, Goldstein DP, Bernstein MR. Repetitive complete and partial hydatidiform mole. Obstet Gynecol. 1989;74(2):217–9.PubMed
37.
Vargas R, Barroilhet LM, Esselen K, Diver E, Bernstein M, Goldstein DP, et al. Subsequent pregnancy outcomes after complete and partial molar pregnancy, recurrent molar pregnancy, and gestational trophoblastic neoplasia: an update from the New England Trophoblastic Disease Center. J Reprod Med. 2014;59(5–6):188–94.PubMed
38.
Gillespie AM, Lidbury EA, Tidy JA, Hancock BW. The clinical presentation, treatment, and outcome of patients diagnosed with possible ectopic molar gestation. Int J Gynecol Cancer. 2004;14(2):366–9.PubMedCrossRef
39.
Yamada Y, Ohira S, Yamazaki T, Shiozawa T. Ectopic Molar Pregnancy: Diagnostic Efficacy of Magnetic Resonance Imaging and Review of the Literature. Case Rep Obstet Gynecol. 2016; 2016:1–7.CrossRef
40.
Sebire NJ, Foskett M, Paradinas FJ, Fisher RA, Francis RJ, Short D, et al. Outcome of twin pregnancies with complete hydatidiform mole and healthy co-twin. Lancet Lond Engl. 2002;359(9324):2165–6.CrossRef
41.
Giorgione V, Cavoretto P, Cormio G, Valsecchi L, Vimercati A, De Gennaro A, et al. Prenatal Diagnosis of Twin Pregnancies with Complete Hydatidiform Mole and Coexistent Normal Fetus: A Series of 13 Cases. Gynecol Obstet Invest. 2017;82(4):404–9.PubMedCrossRef
42.
Wu TWJ, Li YL, Wong KH. The lambda (twin peak) sign. Abdom Radiol. 2018;43(7):1841–1841.CrossRef
43.
McNally L, Rabban JT, Poder L, Chetty S, Ueda S, Chen L may. Differentiating complete hydatidiform mole and coexistent fetus and placental mesenchymal dysplasia: A series of 9 cases and review of the literature. Gynecol Oncol Rep. 2021; 37:100811.
44.
Galeva S, Gil MM, Konstantinidou L, Akolekar R, Nicolaides KH. First-trimester screening for trisomies by cfDNA testing of maternal blood in singleton and twin pregnancies: factors affecting test failure. Ultrasound Obstet Gynecol Off J Int Soc Ultrasound Obstet Gynecol. 2019;53(6):804–9.CrossRef
45.
Tse KY, Chiu KWH, Chan KKL, Chu MMY, Ngu SF, Cheung ANY, et al. A Case Series of Five Patients with Pure or Mixed Gestational Epithelioid Trophoblastic Tumors and a Literature Review on Mixed Tumors. Am J Clin Pathol. 2018;150(4):318–32.PubMedCrossRef
46.
Jones WB, Wagner-Reiss KM, Lewis JL. Intracerebral choriocarcinoma. Gynecol Oncol. 1990;38(2):234–43.PubMedCrossRef
47.
Bakri YN, Berkowitz RS, Khan J, Goldstein DP, von Sinner W, Jabbar FA. Pulmonary metastases of gestational trophoblastic tumor. Risk factors for early respiratory failure. J Reprod Med. 1994;39(3):175–8.
48.
Yingna S, Yang X, Xiuyu Y, Hongzhao S. Clinical Characteristics and Treatment of Gestational Trophoblastic Tumor with Vaginal Metastasis. Gynecol Oncol. 2002;84(3):416–9.PubMedCrossRef
49.
Gadducci A, Carinelli S, Guerrieri ME, Aletti GD. Placental site trophoblastic tumor and epithelioid trophoblastic tumor: Clinical and pathological features, prognostic variables and treatment strategy. Gynecol Oncol. 2019;153(3):684–93.PubMedCrossRef
50.
Kuru O, Cetin C, Iyibozkurt C, Yavuz E. Placental site trophoblastic tumor: report of a tertiary center experience. Eur J Gynaecol Oncol. 2015;36(6):708–10.PubMed
51.
Hui P. Gestational Trophoblastic Tumors: A Timely Review of Diagnostic Pathology. Arch Pathol Lab Med. 2019;143(1):65–74.PubMedCrossRef
52.
Savage J, Adams E, Veras E, Murphy KM, Ronnett BM. Choriocarcinoma in Women: Analysis of a Case Series with Genotyping. Am J Surg Pathol. 2017;41(12):1593–606.PubMedCrossRef
53.
Kaur B, Short D, Fisher RA, Savage PM, Seckl MJ, Sebire NJ. Atypical Placental Site Nodule (APSN) and Association with Malignant Gestational Trophoblastic Disease; A Clinicopathologic Study of 21 Cases: Int J Gynecol Pathol. 2015;34(2):152–8.
54.
Shih IM, Kurman RJ. The Pathology of intermediate trophoblastic tumors and tumor-like lesions. Int J Gynecol Pathol. 2001;20(1):31–47.PubMedCrossRef
55.
Hui P, Wang HL, Chu P, Yang B, Huang J, Baergen RN, et al. Absence of Y chromosome in human placental site trophoblastic tumor. Mod Pathol. 2007;20(10):1055–60.PubMedCrossRef
56.
57.
Chaves MM, Maia T, Cunha TM, Veiga VF. Placental site trophoblastic tumour: the rarest subtype of gestational trophoblastic disease. BMJ Case Rep. 2020;13(10): e235756.PubMedPubMedCentralCrossRef
58.
Brandt KR, Coakley KJ. MR appearance of placental site trophoblastic tumor: a report of three cases. Am J Roentgenol. 1998;170(2):485–7.CrossRef
59.
Kani KK, Lee JH, Dighe M, Moshiri M, Kolokythas O, Dubinsky T. Gestational trophoblastic disease: multimodality imaging assessment with special emphasis on spectrum of abnormalities and value of imaging in staging and management of disease. Curr Probl Diagn Radiol. 2012;41(1):1–10.PubMedCrossRef
60.
Zhou Y, Lu H, Yu C, Tian Q, Lu W. Sonographic characteristics of placental site trophoblastic tumor: Placental site trophoblastic tumor. Ultrasound Obstet Gynecol. 2013 Jun;41(6):679–84.PubMedCrossRef
61.
Sita-Lumsden A, Short D, Lindsay I, Sebire NJ, Adjogatse D, Seckl MJ, et al. Treatment outcomes for 618 women with gestational trophoblastic tumours following a molar pregnancy at the Charing Cross Hospital, 2000–2009. Br J Cancer. 2012 Nov;107(11):1810–4.PubMedPubMedCentralCrossRef
62.
Balachandran K, Salawu A, Ghorani E, Kaur B, Sebire NJ, Short D, et al. When to stop human chorionic gonadotrophin (hCG) surveillance after treatment with chemotherapy for gestational trophoblastic neoplasia (GTN): A national analysis on over 4,000 patients. Gynecol Oncol. 2019 Oct;155(1):8–12.PubMedCrossRef
63.
Bouchard-Fortier G, Ghorani E, Short D, Aguiar X, Harvey R, Unsworth N, et al. Following chemotherapy for gestational trophoblastic neoplasia, do residual lung lesions increase the risk of relapse? Gynecol Oncol. 2020 Sep;158(3):698–701.PubMedCrossRef
64.
Mangili G, Lorusso D, Brown J, Pfisterer J, Massuger L, Vaughan M, et al. Trophoblastic disease review for diagnosis and management: a joint report from the International Society for the Study of Trophoblastic Disease, European Organisation for the Treatment of Trophoblastic Disease, and the Gynecologic Cancer InterGroup. Int J Gynecol Cancer Off J Int Gynecol Cancer Soc. 2014 Nov;24(9 Suppl 3): S109-116.CrossRef
65.
Santaballa A, García Y, Herrero A, Laínez N, Fuentes J, De Juan A, et al. SEOM clinical guidelines in gestational trophoblastic disease (2017). Clin Transl Oncol. 2018 Jan;20(1):38–46.PubMedCrossRef
66.
Amin MB, American Joint Committee on Cancer, American Cancer Society, editors. AJCC cancer staging manual. Eight edition / editor-in-chief, Mahul B. Amin, MD, FCAP; editors, Stephen B. Edge, MD, FACS [and 16 others]; Donna M. Gress, RHIT, CTR-Technical editor; Laura R. Meyer, CAPM-Managing editor. Chicago IL: American Joint Committee on Cancer, Springer; 2017. 1024 p.
67.
Ngan HYS, Seckl MJ, Berkowitz RS, Xiang Y, Golfier F, Sekharan PK, et al. Update on the diagnosis and management of gestational trophoblastic disease. Int J Gynecol Obstet. 2018 Oct; 143:79–85.CrossRef
68.
Organisation mondiale de la santé, Centre international de recherche sur le cancer, editors. Female genital tumours. 5th ed. Lyon: International agency for research on cancer; 2020. (World health organization classification of tumours).
69.
Osborne RJ, Filiaci VL, Schink JC, Mannel RS, Behbakht K, Hoffman JS, et al. Second Curettage for Low-Risk Nonmetastatic Gestational Trophoblastic Neoplasia. Obstet Gynecol. 2016 Sep;128(3):535–42.PubMedPubMedCentralCrossRef
70.
Schink JC, Filiaci V, Huang HQ, Tidy J, Winter M, Carter J, et al. An international randomized phase III trial of pulse actinomycin-D versus multi-day methotrexate for the treatment of low-risk gestational trophoblastic neoplasia; NRG/GOG 275. Gynecol Oncol. 2020 Aug;158(2):354–60.PubMedPubMedCentralCrossRef
71.
Osborne RJ, Filiaci V, Schink JC, Mannel RS, Alvarez Secord A, Kelley JL, et al. Phase III Trial of Weekly Methotrexate or Pulsed Dactinomycin for Low-Risk Gestational Trophoblastic Neoplasia: A Gynecologic Oncology Group Study. J Clin Oncol. 2011 Mar 1;29(7):825–31.PubMedPubMedCentralCrossRef
72.
Ghorani E, Kaur B, Fisher RA, Short D, Joneborg U, Carlson JW, et al. Pembrolizumab is effective for drug-resistant gestational trophoblastic neoplasia. The Lancet. 2017 Nov;390(10110):2343–5.CrossRef
73.
Gamer EIO, Garrett A, Goldstein DP, Berkowitz RS. Significance of chest computed tomography findings in the evaluation and treatment of persistent gestational trophoblastic neoplasia. J Reprod Med. 2004 Jun;49(6):411–4.PubMed
74.
Seckl MJ, Sebire NJ, Fisher RA, Golfier F, Massuger L, Sessa C, et al. Gestational trophoblastic disease: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol Off J Eur Soc Med Oncol. 2013 Oct;24 Suppl 6:vi39–50.
75.
Parker VL, Winter MC, Whitby E, Parker WAE, Palmer JE, Tidy JA, et al. Computed tomography chest imaging offers no advantage over chest X-ray in the initial assessment of gestational trophoblastic neoplasia. Br J Cancer. 2021 Mar 16;124(6):1066–71.PubMedCrossRef
76.
Darby S, Jolley I, Pennington S, Hancock BW. Does chest CT matter in the staging of GTN? Gynecol Oncol. 2009 Jan;112(1):155–60.PubMedCrossRef
77.
Barber EL, Schink JC, Lurain JR. Hepatic metastasis in gestational trophoblastic neoplasia: patient characteristics, prognostic factors, and outcomes. J Reprod Med. 2014 Jun;59(5–6):199–203.PubMed
78.
Abu-Rustum NR, Yashar CM, Bean S, Bradley K, Campos SM, Chon HS, et al. Gestational Trophoblastic Neoplasia, Version 2.2019, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Cancer Netw JNCCN. 2019 Nov 1;17(11):1374–91.
79.
Savage P, Kelpanides I, Tuthill M, Short D, Seckl MJ. Brain metastases in gestational trophoblast neoplasia: an update on incidence, management and outcome. Gynecol Oncol. 2015 Apr;137(1):73–6.PubMedCrossRef
80.
Bezzi C, Monaco L, Ghezzo S, Mathoux G, Bergamini A, Zambella E, et al. 18F-FDG PET/CT May Predict Tumor Type and Risk Score in Gestational Trophoblastic Disease. Clin Nucl Med. 2022 Jun 1;47(6):525–31.PubMedCrossRef
81.
Agarwal R, Harding V, Short D, Fisher RA, Sebire NJ, Harvey R, et al. Uterine artery pulsatility index: a predictor of methotrexate resistance in gestational trophoblastic neoplasia. Br J Cancer. 2012 Mar 13;106(6):1089–94.PubMedPubMedCentralCrossRef
82.
Sita-Lumsden A, Medani H, Fisher R, Harvey R, Short D, Sebire N, et al. Uterine artery pulsatility index improves prediction of methotrexate resistance in women with gestational trophoblastic neoplasia with FIGO score 5-6. BJOG Int J Obstet Gynaecol. 2013 Jul;120(8):1012–5.CrossRef
83.
Sefidbakht S, Hosseini F, Bijan B, Hamedi B, Azizi T. Qualitative and quantitative analysis of diffusion-weighted imaging of gestational trophoblastic disease: Can it predict progression of molar pregnancy to persistent form of disease? Eur J Radiol. 2017 Mar; 88:71–6.PubMedPubMedCentralCrossRef
84.
She C, Li S, Wang X, Lu X, Liang H, Liu X. High-intensity focused ultrasound ablation as an adjuvant surgical salvage procedure in gestational trophoblastic neoplasia chemotherapy with chemoresistance or recurrence: two case reports. Int J Hyperth Off J Eur Soc Hyperthermic Oncol North Am Hyperth Group. 2021;38(1):1584–9.CrossRef
Metadata
Title
Gestational trophoblastic disease: an update
Authors
Tanya Chawla
Genevieve Bouchard-Fortier
Gulisa Turashvili
Ray Osborne
Kalesha Hack
Phyllis Glanc
Publication date
10-02-2023
Publisher
Springer US
Published in
Abdominal Radiology / Issue 5/2023
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-023-03820-5

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