Endometrial and cervical cancer are the most common gynecologic malignancies in the world. Accurate staging of cervical and endometrial cancer is essential for determining the correct treatment approach. The current FIGO (International Federation of Gynecology and Obstetrics) staging system does not include modern imaging modalities. However, magnetic resonance imaging (MRI) has proven to be the most accurate noninvasive imaging modality for staging of endometrial and cervical carcinomas and often assists in patients risk stratification and treatment decisions. Multiparametric MR imaging is increasingly being used in the evaluation of the female pelvis. This approach combines anatomic T2-weighted imaging with functional imaging, i.e. dynamic contrast enhanced MRI (DCE-MRI) and diffusion weighted imaging (DWI). In endometrial and cervical cancer MR imaging is used to guide treatment decisions through an assessment of the depth of myometrial invasion and cervical stromal involvement in endometrial cancer, and of tumor size and parametrial invasion in cervical cancer. However, the efficacy of MRI in achieving accurate local staging is dependent on technique and image quality. In this article we discuss optimization of the MR imaging protocol for endometrial and cervical cancer. The use of thin section high resolution (HR) multi-planar T2 weighted images with simple modifications such as double oblique T2 weighted images supplemented by diffusion weighted imaging and contrast enhanced MRI are reviewed.

Mullerian duct anomalies (MDAs) are rare, affecting approximately 1% of all women and about 3% of women with poor reproductive outcomes. These congenital anomalies usually result from one of the following categories of abnormalities of the mullerian ducts: failure of formation (no development or underdevelopment) or failure of fusion of the mullerian ducts. The American Fertility Society (AFS) classification of uterine anomalies is widely accepted and includes seven distinct categories. MR imaging has consolidated its role as the imaging modality of choice in the evaluation of MDA. MRI is capable of demonstrating the anatomy of the female genital tract remarkably well and is able to provide detailed images of the intra-uterine zonal anatomy, delineate the external fundal contour of the uterus, and comprehensively image the entire female pelvis in multiple imaging planes in a single examination. The purpose of this pictorial essay is to show the value of MRI in the diagnosis of MDA and to review the key imaging features of anomalies of formation and fusion, emphasizing the relevance of accurate diagnosis before therapeutic intervention.

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The pancreas is a retroperitoneal organ with a close anatomic relationship to the peritoneal reflections in the abdomen, including the transverse mesocolon and the small bowel mesentery, and is directly contiguous to peritoneal ligaments such as the hepatoduodenal ligament, gastrohepatic ligament, splenorenal ligament, gastrocolic ligament, and the greater omentum. Understanding of these anatomic relationships of the pancreas is aided by knowledge of its embryologic development. These reflections and ligaments are potential pathways for spread of disease processes such as pancreatitis and pancreatic carcinoma. One can recognize these ligaments and reflections by identifying the blood vessels that traverse them.

Free-form reports were more likely to use ambiguous terminology and/or require review of the actual images for understanding resectability status. The use of a standardized reporting template may improve the usefulness of pancreatic cancer staging reports.