Different tests are available to diagnose the development of gestational trophoblastic disease, depending on signs and symptoms, age and health status, types of tumor, and earlier medical tests. Physical examination, imaging tests, and biopsies are also the diagnostic approaches for diagnosing gestational trophoblastic disease. Besides, it the most common diagnosis of gestational trophoblastic disease includes physical examination (pelvic examination, Human chorionic gonadotropin (HCG) test, and other lab tests), imaging tests (ultrasound, X-ray, Computed tomography (CT or CAT) scan, and Magnetic resonance imaging (MRI)).
Diagnosis of Gestational Trophoblastic Disease
Various tests are now at our disposal to diagnose cancer. These tests are also performed in cases to know whether the gestational trophoblastic disease has spread to parts other than where it started. A biopsy is a sure way to know if you have cancer in a particular part or organ of the body for most types of cancer. Imaging tests can also help the doctors determine if the tumor is primary or if the cancer has metastasized elsewhere in the body.
There are different tests for each person depending upon the following factors –
- Your signs and symptoms
- The age and general health status
- The type of cancer suspected
- The result of earlier medical tests
1. Medical Examinations
In addition to a physical examination, the below-mentioned tests may diagnose Gestational trophoblastic disease or decide the best treatment plan 1.
- Pelvic examination – The doctor may feel the uterus, vagina, ovaries, bladder, and rectum to check for lumps or any unusual changes. This is similar to the physical exam done during an annual gynecologic checkup 2.
- Human chorionic gonadotropin (hCG) test – Tumor markers are substances found at higher-than-normal levels in people with a tumor’s blood, urine, or body tissues. Pregnancy can indeed cause typically high levels of hCG in the blood and urine. High levels of hCG in a woman who is not pregnant could mean that GTD is present. hCG tests are also helpful to monitor a patient’s recovery during and after treatment for GTD 3.
- Other lab tests – Additional blood and urine tests may also be done, including tests to check the thyroid, liver, kidney, and bone marrow function.
2. Imaging Methods
- Ultrasound – Also called a sonogram, an ultrasound uses sound waves to create a picture of the internal organs. An ultrasound wand is inserted into the vagina and targeted at the uterus to take pictures in a transvaginal ultrasound.
- Computed tomography (CT or CAT) scan – A CT scan often the best test to diagnose and monitor a tumor. A CT scan clicks pictures of the body from inside using x-rays taken from different angles. A computer combines photos into a detailed, 3-dimensional image that shows abnormalities or tumors. A CT scan is to measure the tumor’s size or help doctors determine whether cancer has spread to the gut lining or the liver. Sometimes, a particular dye known as contrast medium is provided before the scan to receive a better-detailed image. This dye can be provided as a pill or liquid to swallow or injected into a patient’s vein.
- X-ray – An x-ray is a way to create a picture of the structures inside of the body using a small amount of radiation. An x-ray will help to see if the tumor has spread outside the uterus.
3. MRI OR Magnetic resonance imaging
Magnetic resonance imaging (MRI) – A MRI uses magnetic fields, not x-rays, to produce detailed body images. A specific dye known as contrast medium is provided before the scan to create a better picture. This dye can be provided as a pill or liquid to swallow or injected into a patient’s vein.
- 1.Ngan HYS, Seckl MJ, Berkowitz RS, et al. Update on the diagnosis and management of gestational trophoblastic disease. Int J Gynecol Obstet. Published online October 2018:79-85. doi:10.1002/ijgo.12615
- 2.Dhanda S, Ramani S, Thakur M. Gestational Trophoblastic Disease: A Multimodality Imaging Approach with Impact on Diagnosis and Management. Radiology Research and Practice. Published online 2014:1-12. doi:10.1155/2014/842751
- 3.Aminimoghaddam S, Yarandi F, Nejadsalami F, Taftachi F, Noor B, Mahmoudzadeh F. Human chorionic gonadotrophin as an indicator of persistent gestational trophoblastic neoplasia. Med J Islam Repub Iran. 2014;28:44. https://www.ncbi.nlm.nih.gov/pubmed/25405110