Imaging of the vagina and vulva

The imaging evaluation of female lower genital tract cancers has undergone dramatic changes in the last two decades. Technical improvements and increased availability of cross-sectional modalities (US, CT, MR) have increased their use to such an extent that they have largely replaced more conventional imaging techniques. US is of limited value in the staging of vaginal and vulvar malignancies. CT is most useful for staging more advanced disease of the vagina and vulva. It is widely available and provides quick imaging time. CT is used in the detection and biopsy of suspected lymph nodes and metastases. MRI provides the best soft tissue contrast and is the most useful imaging modality available to evaluate carcinomas of the vagina and vulva. Future advancements in the imaging evaluation of vaginal and vulvar cancers will likely focus on functional imaging.