Gestational Trophoblastic Disease: Diagnosis

Approved by the Cancer.Net Editorial Board, 07/2014

ON THIS PAGE: You will find a list of the common tests, procedures, and scans that doctors can use to find out what’s wrong and identify the cause of the problem. To see other pages, use the menu on the side of your screen.

Doctors use many tests to diagnose GTD, determine whether it is cancerous, and if so, find out if it has spread to another part of the body, called metastasis. Some tests may also determine which treatments may be the most effective. Imaging tests may also be used to find out whether a cancerous GTD has spread. This list describes options for diagnosing GTD, and not all tests listed will be used for every person. Your doctor may consider these factors when choosing a diagnostic test:

  • Type of disease suspected
  • Signs and symptoms
  • Previous test results

In addition to a physical examination, the following tests may be used to diagnose GTD:

Pelvic examination. The doctor may feel the uterus, vagina, ovaries, fallopian tubes, bladder, and rectum to check for lumps or any unusual changes. This is similar to the physical exam done when women have an annual gynecologic check-up.

Beta human chorionic gonadotropin (hCG) test. Tumor markers are substances found at higher than normal levels in the blood, urine, or body tissues of some people with a tumor. Women who are pregnant normally produce high levels of the hormone beta hCG in their blood and urine. High levels of beta hCG in a woman who is not pregnant could mean that GTD is present. hCG tests are also helpful tests during and after treatment for GTD, to monitor a woman’s recovery.

Other lab tests. Additional blood and urine tests may also done, including tests to check the woman’s thyroid, liver, kidney, and bone marrow function.

Ultrasound. Also called a sonogram, an ultrasound uses sound waves to create a picture of internal organs. In a transvaginal ultrasound, an ultrasound wand is inserted into the vagina and aimed at the uterus, to obtain the pictures.

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. A chest x-ray may be done to see if the doctor believes there may be spread outside of the uterus.

Computed tomography (CT or CAT) scan. A CT scan creates a three-dimensional picture of the inside of the body with an x-ray machine. A computer then combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. A CT scan can also be used to measure the tumor’s size. Sometimes, a special dye called a contrast medium is given before the scan to provide better detail on the image. This dye is injected into a patient’s vein and given as a drink to swallow.

Magnetic resonance imaging (MRI). An MRI uses magnetic fields, not x-rays, to produce detailed images of the body. MRI can also be used to measure the tumor’s size. A special dye called a contrast medium is given before the scan to create a clearer picture. This dye can be injected into a patient’s vein or given as a pill to swallow. In GTD, MRIs are most often used to see a patient’s brain.

After diagnostic tests are done, your doctor will review all of the results with you. If the diagnosis is GTD, these results also help the doctor describe the disease in more detail; this is called staging.

The next section helps explain the different stages for this type of tumor. Use the menu on the side of your screen to select Stages, or you can select another section, to continue reading this guide.