MRI in pregnant patients with suspected abdominal and pelvic cancer: a practical guide for radiologists

The incidence of abdominal and pelvic cancer in pregnancy is low, but it's rising as the population of pregnant women gets older. Depending on disease stage, gestational age and patient's preference, active surveillance but also surgery and chemotherapy during pregnancy are feasible options. A correct diagnosis and staging of the tumor is crucial for choosing the best therapeutic approach. Moreover, a reproducible modality to assess the treatment response is requested. Magnetic resonance imaging (MRI) is commonly used with good results for the local staging and treatment response evaluation of most abdominal and pelvic cancers in non-pregnant patients and it's considered relatively safe during pregnancy. The purpose of this article is to analyze the most relevant topics regarding the use of MRI in pregnant women with abdominal and pelvic cancer. We discuss MRI safety during pregnancy, including the use of gadolinium-based contrast agents (GBCAs), how to prepare the patient for the exam and MRI technique. This will be followed by a brief review on the most common malignancies diagnosed during pregnancy and their MRI appearance.