盆腔廓清术（PE）是一种根治性手术方法，旨在治愈晚期盆腔恶性肿瘤，需要整块切除多个盆腔器官。虽然该手术是激进的，但它在提高长期生存率方面显示出了希望，目前其手术死亡率与原发性盆腔癌的选择性切除术相当。影像学在术前计划中发挥着至关重要的作用，其中 MRI、CT 和 PET/CT 对于评估癌症范围和制定手术路线图至关重要。本文介绍了由 ESGAR、SAR、ESUR 和 PelvEx Collaborative 联合开发的 PE 背景下成像的临床实践指南。这些指南旨在标准化影像方案和报告，以改善盆腔癌多学科治疗的术前评估并促进决策。我们的建议强调了多学科方法的重要性以及清晰、精确的成像报告以优化患者护理的必要性。临床相关性声明：我们的建议强调多学科方法的重要性以及清晰、精确的影像报告以优化患者护理的必要性。要点：MRI 对于盆腔廓清术的局部分期是强制性的。建议使用结构化报告（使用本指南中提供的模板）。影像学的多学科审查对于手术计划至关重要。© 2024。作者获得欧洲放射学会的独家许可。

Pelvic exenteration (PE) is a radical surgical approach designed for the curative treatment of advanced pelvic malignancies, requiring en-bloc resection of multiple pelvic organs. While the procedure is radical, it has shown promise in enhancing long-term survival and is now comparable in surgical mortality to elective resections for primary pelvic cancers. Imaging plays a crucial role in preoperative planning, with MRI, CT, and PET/CT being pivotal in assessing the extent of cancer and formulating a surgical roadmap. This paper presents clinical practice guidelines for imaging in the context of PE, developed jointly by ESGAR, SAR, ESUR, and the PelvEx Collaborative. These guidelines aim to standardize imaging protocols and reporting to improve the preoperative assessment and facilitate decision-making in the multidisciplinary treatment of pelvic cancers. Our recommendations underscore the importance of a multidisciplinary approach and the need for clear and precise imaging reports to optimize patient care. CLINICAL RELEVANCE STATEMENT: Our recommendations underscore the importance of a multidisciplinary approach and the need for clear and precise imaging reports to optimize patient care. KEY POINTS: MRI is mandatory for local staging in pelvic exenteration. Structured reporting (using the template provided in this guide) is recommended. Multidisciplinary review of imaging is critical for surgical planning.© 2024. The Author(s), under exclusive licence to European Society of Radiology.