Ultrasound scans can give an image of the uterus to determine if cancer is present.
Radiology can help determine the presence of uterine cancer, and the kind of appropriate treatment to give the patient. The patient is first given an ultrasound, in which high-frequency sound waves are bounced off the uterus to produce pictures of it. Sonohysterography will also be used to get a more detailed internal picture of the uterus and give a definitive diagnosis of cancer.
Prior to Ultrasound
Women will usually be referred for an ultrasound if they have been experiencing particular symptoms that might cause the doctor to suspect uterine cancer. These symptoms include pelvic pain, abnormal bleeding, or other menstrual irregularities. The ultrasound scan can also help visualize features of the uterus that have been felt upon examination, such as ovarian cysts and uterine fibroids, and ovarian or uterine tumors.
Performing the Ultrasound
The ultrasound can be performed abdominally, (transabdominal) or vaginally (transvaginal).
A transvaginal ultrasound is usually performed to view the endometrium, or the lining of the uterus (including its thickness), and the ovaries. Transvaginal ultrasound also gives a good picture of the muscular walls of the uterus, called the myometrium. Uterine cancer can occur in both the endometrium and myometrium.
Sonohysterography
Sonohysterography allows for a more in-depth investigation of the uterine cavity. These exams are typically performed to detect uterine abnormalities, scars, endometrial polyps, fibroids, and uterine cancer, especially in patients who have been experiencing abnormal uterine bleeding.
Performing the Sonohysterography
The patient is positioned for a pelvic exam, with her feet in stirrups. The cervix will be cleansed, and a catheter will be inserted into the uterine cavity. The transvaginal probe will be inserted into the vaginal canal, and up into the cervix. Sterile saline will be injected through the catheter into the uterine cavity as ultrasound is being performed, to try to inflate it to visualize various features clearly. Inadequate inflation of the uterine cavity with the saline injection may be caused by uterine adhesions (scarring) or large benign tumors called fibroids, which may partially block the uterine cavity and make visualization difficult.
Results of the Radiologic Scans
Ultrasound and sonohysterography are useful radiological tools for the diagnosis of uterine conditions, including uterine cancer. Radiology helps determine the locations of certain abnormalities, such as fibroids or polyps, which can be important when establishing a treatment or management strategy for a patient's particular condition. The results will determine the course of treatment. If uterine cancer is diagnosed, patients will usually undergo a hysterectomy (removal of the uterus).
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