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ULTRASONOGRAPHY IN

12GYNAECOLOGICAL CANCERS

Daniela Fischerova, MD, PhD

Abstract Keywords: ultrasound, cervical cancer, endometrial
cancer, ovarian cancer, FIGO staging, IOTA
Ultrasound is the primary imaging modality in
gynaecological oncology. Over the last decade, there Introduction
have been huge steps forward in technology which
has led to dramatic improvements in the quality of In the last five years, our view on the use of imaging in
ultrasound imaging. If performed by an experienced gynaecological malignancies, in particular of ultrasound
sonographer, ultrasound has an invaluable role in the diagnostics, has changed dramatically. The inclusion of
primary diagnosis of gynaecological cancer, in the ultrasound imaging alongside modern imaging methods
assessment of tumour extent in the pelvis and abdominal in gynaecological oncology was limited until recently. In
cavity, in the evaluation of the treatment response and the assessment of cervical cancer, for example, ultrasound
in follow-up. Ultrasound is also a valuable procedure for was only recommended to detect renal pelvic dilatation.
monitoring patients treated with fertility-sparing surgery. Ultrasound has, however, undergone significant
Furthermore, it is an ideal technique to guide tru-cut technical development in the last ten years. In particular,
biopsy for the collection of material for histology. Taking the development of high resolution endovaginal
into consideration that besides its accuracy, ultrasound probes allows a detailed view of the pelvic anatomy
is a commonly available, non-invasive and inexpensive comparable to magnetic resonance imaging (MRI) and
imaging method that can be utilised without any risk or have led to the routine use of ultrasound in gynaecology
discomfort to the patient, it is time to reconsider its role (Figure 1). Transabdominal scans additionally provide
in gynaecologic oncology and to allocate resources for detailed information on the status of parenchymatous
a specialized education of future experts in ultrasound organs, lymph nodes and peritoneum in the abdomen.
imaging in gynaecology.

Figure 1. Bulky cervical cancer on ultrasound and magnetic resonance imaging. A bulky tumour infiltrating the anterior lip of cervix and
cervical stroma up to internal orificium on scheme (A), MR imaging (B), transvaginal scan (C), Doppler visualisation of tumor vessels in
order to establish the final tumor size (D), intraoperative view of the whole specimen and transverse section of tumor corresponding to
the level of a section line on previous imaging (E). MRI-magnetic resonance imaging, TVS-transvaginal scan.

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