After evacuation of a hydatidiform mole, which imaging study is used to screen for metastatic disease?

After evacuation of a hydatidiform mole, which imaging study is used to screen for metastatic disease?

• A. Chest X-ray
• B. Pelvic ultrasound
• C. Abdominal ultrasound
• D. MRI chest

Answer: (A)

Metastatic spread from gestational trophoblastic disease most commonly goes to the lungs through the bloodstream. Because the lungs are the first and most likely site, the initial way to screen for metastasis after evacuation of a hydatidiform mole is a chest X-ray. It quickly and cheaply reveals pulmonary nodules that would indicate metastatic disease. If the chest X-ray is normal but suspicion remains high, more detailed imaging like a CT scan of the chest can be used for better sensitivity. Pelvic ultrasound checks for persistent intrauterine tissue rather than distant spread, so it isn’t the right test for screening metastasis. Abdominal ultrasound isn't the standard screening tool for metastatic GTD and would only come into play if there’s reason to suspect liver involvement, in which case cross-sectional imaging would be preferred.

Metastatic spread from gestational trophoblastic disease most commonly goes to the lungs through the bloodstream. Because the lungs are the first and most likely site, the initial way to screen for metastasis after evacuation of a hydatidiform mole is a chest X-ray. It quickly and cheaply reveals pulmonary nodules that would indicate metastatic disease. If the chest X-ray is normal but suspicion remains high, more detailed imaging like a CT scan of the chest can be used for better sensitivity. Pelvic ultrasound checks for persistent intrauterine tissue rather than distant spread, so it isn’t the right test for screening metastasis. Abdominal ultrasound isn't the standard screening tool for metastatic GTD and would only come into play if there’s reason to suspect liver involvement, in which case cross-sectional imaging would be preferred.