Gynaecological Malignancies, Cervical, Endometrial, and Ovarian Cancer Staging — WACS Viva & Clinical Scenarios (Obstetric and Gynaecological Imaging)

Exam-style gynaecological malignancies, cervical, endometrial, and ovarian cancer staging viva scenarios with examiner probes and model answers for Radiology…

Scenarios covered

• SCENARIO 1: A 48-year-old woman presents with abnormal vaginal bleeding and a biopsy-confirmed cervical squamous cell carcinoma. You are provided with a high-resolution multiplanar pelvic MRI. Describe your systematic reporting approach, identify the key anatomical imaging features that determine parametrial invasion, and state the FIGO stage cutoff that changes management from radical surgery to definitive concurrent chemoradiotherapy.
• SCENARIO 2: A 62-year-old postmenopausal woman with abnormal uterine bleeding has a histologically confirmed Grade 2 endometrioid adenocarcinoma. Review the sagittal T2-weighted, axial oblique T2-weighted, and dynamic contrast-enhanced pelvic MRI images. Outline how depth of myometrial invasion is accurately measured, explain the significance of the subendometrial enhancement zone, and differentiate FIGO Stage IA from Stage IB and Stage II disease.
• SCENARIO 3: A 55-year-old woman presents with progressive abdominal distension, early satiety, and a serum CA-125 level of 1200 U/mL. Contrast-enhanced abdominopelvic CT demonstrates a complex multilocular cystic-solid right adnexal mass. Detail the systematic abdominal and pelvic CT review areas required to detect peritoneal carcinomatosis, omental disease, and regional nodal metastases for surgical cytoreduction planning.
• SCENARIO 4: A 52-year-old patient who completed definitive chemoradiotherapy for Stage IIB cervical carcinoma 14 months ago presents with new pelvic pain. Explain how pelvic MRI and functional diffusion-weighted imaging (DWI) with ADC mapping differentiate post-radiation fibrosis from central tumor recurrence, and describe the role of FDG PET-CT in this clinical setting.
• SCENARIO 5: Describe the optimal multiplanar magnetic resonance imaging protocol for pre-treatment staging of cervical and endometrial malignancies, detailing patient preparation steps to reduce bowel motion artifacts, sequence selection, imaging planes relative to organ axes, and the role of dynamic contrast enhancement.