Three-dimensional ultrasound for assessing women with gynecological cancer: a systematic review

Three-dimensional ultrasound (3D-US) is a new imaging technique that has become available in clinical practice. It is being increasingly used in women with gynecological cancer. The goal of this article is to review critically current evidence of the role of this technique in this clinical setting.

Through Medline search (2001-2010) 46 studies using 3D-US in women with gynecological cancer were identified (28 studies involving ovarian cancer, 15 studies involving endometrial cancer and 6 studies involving cervical cancer). A systematic review of these studies was performed.

Most studies were prospective and observational. Series were small in most of them. Ten studies addressed to technical and reproducibility issues. All of them demonstrate that 3D-US is a reproducible technique among examiners. Studies involving ovarian cancer showed that gray-scale 3D-US is not superior to conventional 2D-US for predicting ovarian cancer. Tumor vascular assessment by 3D power Doppler showed that this method might be useful in a selected subset of adnexal masses. Studies involving endometrial cancer showed that endometrial volume estimation is more specific than endometrial thickness measurement for predicting endometrial cancer. This method is useful for determining myometrial infiltration in women with endometrial cancer. The role of 3D power Doppler in endometrial cancer is controversial. Studies involving cervical cancer showed that tumor vascularity as assessed by 3D power Doppler correlates with prognostic tumor features.

Three-dimensional ultrasound is a new imaging technique that offers unique ways for assessing women with gynecologic cancer. Current evidence shows that it is reproducible. It might be useful in some clinical circumstances. Further studies are needed to establish its role in clinical practice in gynecologic oncology.