Role of imaging in the evaluation of pelvic cancer.

The last 15 years have witnessed dramatic advances in the detection, assessment, and management of cancer. Progress is due to increased knowledge of the basic biology of cancer, oncogenes, and immunologic mechanisms controlling cancer; a better understanding of the disease and its diagnosis and management; and improved imaging technology. Diagnostic imaging has been revolutionized by the development of microcomputers and television instrumentation, and by technological advances producing better ultrasound transducers, x-ray detectors, and more homogeneous magnetic fields, as well as more precise magnetic coils and better software. At the time that we have come to understand more about cancer prognostic variables, imaging has developed to offer a unique display of a number of morphologic factors such as tumor size, location, depth of invasion, lymph node status, presence of metastases, and overall stage of disease. Just as accurate knowledge of prognostic variables is essential for designing optimal treatment protocols, it is fundamental in rendering a useful radiology report. Because "the first treatment should be the best possible since it has the greatest chance for curing the patient," an assessment of the full extent of cancer prior to the initiation of treatment is mandatory. Two elements in the clinical setting contribute to the ability to capitalize on these advances and breakthroughs: continuing education about progress in the field of oncology, and a motivated team of treatment specialists. This combination of application of new knowledge and technological advances and team work will promote the necessary environment for the conquest for cancer.