Radiological assessment

In this chapter, we focus on the use of radiologic imaging in the preoperative assessment of endometrial cancer (EC). It is important that the gynecologist, the radiologist, and the other members of the multidisciplinary team understand the diagnostic performance, advantages, and limitations of each imaging method. Up to now, neither a consensus has been reached nor recommendations made regarding the best imaging to assess the local extension of EC, and clinical routines vary between countries and hospitals. It is potentially beneficial to identify patients with high-risk (HR) EC who present deep stromal or cervical invasion before surgery, as they should either undergo a radical hysterectomy with bilateral salpingo-oophorectomy or systematic lymph-node dissection. Both transvaginal ultrasound (TVS) and magnetic resonance imaging (MRI) are imaging methods that can be used for this purpose. The primary aim of this chapter is to present the role of MRI in the assessment of local tumor extension in women with EC. The secondary goal is to briefly introduce the role of computed tomography (CT) and positron emission tomography combined with computed tomography (PET-CT), imaging methods that are primarily used to detect lymph node and distant metastasis.