Imaging in Vulval Cancer.

Area of Science:

• Gynecologic Oncology
• Diagnostic Imaging
• Radiology

Background:

• Vulval cancer is a rare gynecologic malignancy, representing 3% of cases.
• Imaging modalities are used for diagnosis and staging, but guidelines vary due to limited evidence.
• Global incidence was 47,000 cases in 2022.

Purpose of the Study:

• To review the current evidence on the role of diagnostic imaging in vulval cancer.
• To assess the efficacy of various imaging modalities for primary tumors, nodal assessment, and distant metastases.

Main Methods:

• A systematic literature search was conducted on PubMed.
• MeSH terms used were 'vulval neoplasm' and 'diagnostic imaging'.

Main Results:

• Insufficient evidence exists for routine imaging of primary vulval tumors.
• No single imaging modality demonstrates superior sensitivity or specificity for nodal assessment.
• CT CAP (Computed Tomography of the Chest, Abdomen, and Pelvis) and FDG-PET/CT (Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography) have the most evidence for detecting distant metastases.

Conclusions:

• The evidence base for imaging in vulval cancer is limited by study heterogeneity, small sample sizes, and retrospective designs.
• Further high-quality research is needed to establish optimal imaging protocols for vulval cancer management.