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Which scan is best for endometria carcinoma to stage

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endometrial cancer AND staging MRI

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ESGO endometrial carcinoma staging MRI CT guidelines 2025

Pelvic MRI with contrast and diffusion-weighted imaging is the best scan for local preoperative staging of endometrial carcinoma.
It is best for assessing:
  • Depth of myometrial invasion
  • Cervical stromal involvement
  • Uterine serosal/adnexal extension
  • Pelvic lymph nodes, with limited sensitivity for microscopic nodal disease
For possible advanced or metastatic disease, add a contrast-enhanced CT of chest, abdomen, and pelvis. FDG PET-CT can be useful when nodal or distant metastasis is suspected, especially in high-risk histology, but it does not replace MRI for detailed local uterine staging.
Ultrasound is useful for initial assessment of endometrial thickening, not definitive cancer staging. MRI’s soft-tissue contrast supports accurate local staging. Grainger & Allison’s Diagnostic Radiology, block 7, lines 135-143.

Best scan for suspect of ovarian carcinoma

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ovarian cancer AND imaging staging

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ACR appropriateness criteria suspected ovarian cancer initial imaging CT MRI 2025

For a suspected ovarian carcinoma, the usual pathway is:
  1. First test to characterize an adnexal/ovarian mass:
    Transvaginal pelvic ultrasound with Doppler.
  2. Best scan for staging once cancer is suspected or confirmed:
    Contrast-enhanced CT of the chest, abdomen, and pelvis.
CT best evaluates peritoneal/omental spread, ascites, lymph nodes, liver and other distant metastases, and helps determine whether primary debulking surgery appears feasible. Grainger & Allison’s Diagnostic Radiology, block 7, lines 530-537.
MRI pelvis is mainly a problem-solving test when ultrasound is indeterminate or better local characterization of an adnexal mass is needed. FDG PET-CT is not routine for initial preoperative staging, but can help in suspected recurrence or equivocal CT/MRI findings. A 2024 meta-analysis comparing CT and PET-CT for advanced ovarian-cancer staging is indexed as PMID 38523146.
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