The diagnosis, treatment, and management of gynecologic malignancies benefit from both positron emission tomography/computed tomography (PET/CT) and MRI. PET/CT provides important information on the local extent of disease as well as diffuse metastatic involvement. MRI offers soft tissue delineation and loco-regional disease involvement. The combination of these two technologies is key in diagnosis, treatment planning, and evaluating treatment response in gynecological malignancies. This review aims to assess the performance of PET/MRI in gynecologic cancer patients and outlines the technical challenges and clinical advantages of PET/MR systems when specifically applied to gynecologic malignancies.

The diagnosis of a common cause of chronic pelvic pain can be made by visualizing reflux in the ovarian veins. Fluoroscopic venography is the gold standard for diagnosing ovarian vein reflux, but it is an invasive technique that exposes patients to ionizing radiation. MRI, with its lack of ionizing radiation and capability of high-temporal and spatial-resolution vascular imaging, has the potential to provide similar diagnostic information. This retrospective report describes and assesses the utility of a dynamic contrast-enhanced MRI technique based on Differential Subsampling with Cartesian Ordering (DISCO)–MRI in 30 patients with chronic pelvic pain. Among the 14 patients who underwent both DISCO–MRI and fluoroscopic venograms, 11 (78.6%) exhibited concordant results, while 3 patients (21.4%) had discordant findings. These results suggest the potential of multiphasic contrast-enhanced DISCO–MRI as a non-invasive diagnostic tool for evaluating chronic pelvic pain.