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Updates on Imaging of Common Urogenital Neoplasms—2nd Edition

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A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Methods and Technologies Development".

Deadline for manuscript submissions: 31 July 2026 | Viewed by 4549

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Dr. Athina C Tsili

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Department of Clinical Radiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, University Campus, 451 10 Ioannina, Greece
Interests: urogenital neoplasms; diagnostic imaging
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Special Issue Information

Dear Colleagues,

This Special Issue is on the multimodal imaging of common urogenital neoplasms. Significant technological advances in imaging, including ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI) and nuclear medicine have brought many diagnostic benefits to genitourinary oncology.

We are pleased to invite you to submit papers outlining updates on imaging common urogenital neoplasms.

Accurate imaging in patients with suspected genitourinary cancers may lead to the early diagnosis of primary tumors, more accurate tumor staging and consequent adequate and more tailored treatment planning, evaluation of treatment efficacy, and the detection of recurrence. This Special Issue aims to highlight the role of the most commonly used cross-sectional imaging techniques, including US, CT, MRI and fluorodeoxyglucose (FDG)-positron emission tomography (PET)-CT, in the work-up of common urogenital malignancies.

In this Special Issue, original research articles and reviews are welcome. Research areas may include (but are not limited to) the following: prostate carcinomas, urinary bladder carcinomas, renal cell carcinomas, testicular neoplasms, ovarian neoplasm, uterine neoplasms, and uterine cervix carcinomas.

I look forward to receiving your contributions.

Dr. Athina C Tsili
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

urogenital neoplasms
renal cell carcinoma
prostatic neoplasms
urinary bladder neoplasms
testicular neoplasms
uterine neoplasms
ovarian neoplasms
ultrasonography
computed tomography
magnetic resonance imaging

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Related Special Issue

Updates on Imaging of Common Urogenital Neoplasms in Cancers (11 articles)

Published Papers (5 papers)

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Research

Jump to: Review

15 pages, 1672 KB

Open AccessArticle

Colour Doppler Ultrasonography in the Assessment of Intratesticular Lesions: Influence of Lesion Size and Vascular Pattern

by Emily C. Bartlett, Dean Y. Huang, Marta Piorkowska, Maria E. Sellars, Jane L. Clarke, Seshadri Sriprasad, Gordon H. Muir, Daniel J. Quinlan and Paul S. Sidhu

Cancers 2026, 18(5), 741; https://doi.org/10.3390/cancers18050741 - 25 Feb 2026

Cited by 1 | Viewed by 596

Abstract

Background/Objectives: Conventional Colour Doppler Ultrasonography (CDUS) is widely used to assess vascularity in focal intratesticular lesions, yet the influence of lesion size on flow detection and the diagnostic utility of vascular distribution patterns remain unclear. We evaluated (i) whether lesion size affects CDUS detection of intralesional vascularity and (ii) whether vascular patterns associated with disruption of normal intratesticular vascular architecture are linked to diagnostic groupings. Methods: This retrospective single-centre study screened 12,189 testicular ultrasound examinations (1999–2009) and included histologically confirmed focal lesions with archived greyscale and CDUS images. To avoid within-patient clustering, one lesion per patient (the largest if multiple) was analysed (99 patients/lesions). Two blinded radiologists assessed vascularity (present/absent) and, for vascularised lesions, peripheral vascularity and intralesional patterns (criss-cross; disordered/haphazard). A derived composite “disrupted” pattern comprised criss-cross or disordered/haphazard flow. Results: Intralesional vascularity was present in 85/99 (85.9%) lesions. Vascularity was more common in neoplastic vs. non-neoplastic lesions (78/82 [95.1%] vs. 7/17 [58.8%]; p < 0.001) and in malignant vs. benign lesions (64/68 [94.1%] vs. 21/31 [67.7%]; p = 0.001). Lesion size was not associated with vascularity (the smallest vascularised lesion was 2 mm; logistic regression was non-significant). Among vascularised lesions, the composite disrupted pattern was more frequent in neoplastic vs. non-neoplastic (OR 11.67) and malignant vs. benign lesions (OR 5.90). Four of 14 avascular lesions were malignant/neoplastic. Conclusions: With optimised settings, CDUS vascularity detection did not appear size-limited and was strongly associated with neoplasia and malignancy, although avascularity did not exclude malignancy. A composite disrupted vascular pattern may be a practical, reproducible reporting descriptor warranting prospective validation. Full article

(This article belongs to the Special Issue Updates on Imaging of Common Urogenital Neoplasms—2nd Edition)

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13 pages, 707 KB

Open AccessArticle

Does It Make Sense to Perform Prostate Magnetic Resonance Imaging in Men with Normal PSA (<4 ng/mL)?

by Pieter De Visschere, Camille Berquin, Pieter De Backer, Joris Vangeneugden, Eva Donck, Thomas Tailly, Valérie Fonteyne, Sofie Verbeke, Sigi Hendrickx, Nicolaas Lumen, Daan De Maeseneer, Geert Villeirs and Charles Van Praet

Cancers 2026, 18(3), 423; https://doi.org/10.3390/cancers18030423 - 28 Jan 2026

Viewed by 584

Abstract

Objective: We evaluate the performance and relevance of MRI to detect csPC in men with normal PSA. Methods: Out of our database of patients referred for prostate MRI, we selected men with PSA < 4 ng/mL for whom histopathology or at least 2 years of clinical follow-up data were available as standard of reference. Subgroup analyses were performed for the patients with PSA < 3 ng/mL, <2 ng/mL, and 2–3.9 ng/mL. The reasons for prostate MRI referral despite their normal PSA level were retrieved by exploring the patients’ files. The prostate MRIs were reported according to the Prostate Imaging and Reporting Data System (PI-RADS), and the overall assessment score was registered. For evaluation of the performance, PI-RADS ≥ 3 was set as a threshold for a positive exam. The patients without PC or only International Society of Urological Pathology (ISUP) grade group 1 PC (Gleason 3+3) were considered as one category having no csPC. The performance of prostate MRI was separately evaluated for detection of ISUP ≥ 2 and for ISUP ≥ 3 csPC. Results: A total of 148 men were included, with PSA ranging from 0.42 to 3.99 ng/mL (median 2.95, IQR 1.68–3.50) and age ranging from 36 to 84 years (median 58, IQR 52–66). A total of 74 men (50.0%) had a PSA level < 3 ng/mL, 42 (28.4%) had a PSA level < 2 ng/mL, and 106 (71.6%) had a PSA level of 2–3.9 ng/mL. They were referred for prostate MRI for a wide variety, and usually a combination of, reasons, such as younger age (<60 years in 55.4%, N = 82; <50 years in 17.6%, N = 26), abnormal digital rectal examination in 31.8% of cases (N = 47), suspicious PSA dynamics in 29.7% (N = 44), positive familial history in 27.0% (N = 40), clinical signs of prostatitis in 18.2% (N = 27), suspicious findings on Transrectal Ultrasound (TRUS) in 16.9% (N = 25), hematospermia in 7.4% (N = 11), hematuria in 4.1% (N = 6), incidental hot spot in the prostate on Fluoro-Deoxy-Glucose (FDG) Positron Emission Tomography (PET)–Computed Tomography (CT) in 4.1% (N = 6), lymphadenopathies on CT in 2.7% (N = 4), or severe patient anxiety in 3.4% (N = 5). Overall, ISUP ≥ 2 PC was present in 18.9% (N = 28) of cases, and MRI detected this with a sensitivity of 92.9%, a specificity of 66.7%, and a positive predictive value of 39.4%. ISUP ≥ 3 PC was present in 9.5% (N = 14) of cases, and prostate MRI detected this with a sensitivity of 100%, a specificity of 61.2%, and a positive predictive value of 21.2%. In patients with PSA < 2 ng/mL (N = 42), no csPC was found, but MRI generated false positives in 33.3%. Conclusions: Performing prostate MRI in men with normal PSA (<4 ng/mL) seems useful if there are other reasons that increase the clinical suspicion of csPC. In about one-fifth of these patients, csPC is present and MRI has high sensitivity for its detection. Prostate MRI has, however, low positive predictive value in this patient group, and clinicians should be aware of the risk of false-positive MRI. Below a PSA level of 2 ng/mL, no csPC was found and prostate MRI generated only false positives, suggesting limited value in this subgroup. Full article

(This article belongs to the Special Issue Updates on Imaging of Common Urogenital Neoplasms—2nd Edition)

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14 pages, 3525 KB

Open AccessArticle

Prediction of Resectability of Peritoneal Disease in Ovarian Cancer Patients Using the Peritoneal Cancer Index (PCI) and Fagotti Score on MRI

by Marianna Konidari, Sofia Gourtsoyianni, Nikolaos Thomakos, Georgia Lymperopoulou, Chara Tzavara, Vasilios Pergialiotis, Alexandros Rodolakis, Lia Angela Moulopoulos and Charis Bourgioti

Cancers 2026, 18(1), 165; https://doi.org/10.3390/cancers18010165 - 2 Jan 2026

Cited by 1 | Viewed by 1131

Abstract

Background/Objectives: Cytoreduction status is a critical prognostic factor in ovarian cancer, yet preoperative selection of patients suitable for primary debulking surgery and accurate prediction of surgical outcome remain challenging. This study aimed to evaluate the prognostic ability of MRI-based Fagotti score and Peritoneal Cancer Index (PCI) for predicting resectability of peritoneal disease in ovarian cancer patients. Methods: This was a prospective single-center observational study. Patients with suspected primary ovarian cancer who underwent preoperative MRI of the abdomen and pelvis with a dedicated protocol were considered. MRI-based Fagotti score and PCI were determined by two readers independently, using a combination of T2W, Diffusion-Weighted Imaging (DWI), and contrast-enhanced T1W sequences. In cases of discordance, a third radiologist reviewed the scans and consensus was reached. ROC analysis and logistic regression were used to evaluate prognostic performance. The reference standard to predict resectability was optimal cytoreduction defined as residual disease ≤1 cm. Results: Forty-six women with epithelial ovarian cancer (mean age 56.3 ± 2.6 years) who underwent preoperative MRI, followed by laparoscopy and/or laparotomy, were included in the study. Both MRI-based Fagotti score and PCI showed high predictive value for predicting resectability (AUC 0.92 and 0.94, respectively). Optimal cut-offs were ≤6 for Fagotti score and ≤20 for PCI. Patients with scores below these thresholds had >60-fold (Fagotti) and >100-fold (PCI) increased odds for successful primary cytoreduction (p < 0.001). Conclusions: MRI-based Fagotti score and PCI may serve as powerful noninvasive predictors of surgical outcome in ovarian cancer. MRI may reliably guide treatment decisions, reducing unnecessary laparotomies and optimizing patient selection. Full article

(This article belongs to the Special Issue Updates on Imaging of Common Urogenital Neoplasms—2nd Edition)

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23 pages, 4556 KB

Open AccessArticle

Radiomics-Based Detection of Germ Cell Neoplasia In Situ Using Volumetric ADC and FA Histogram Features: A Retrospective Study

by Maria-Veatriki Christodoulou, Ourania Pappa, Loukas Astrakas, Evangeli Lampri, Thanos Paliouras, Nikolaos Sofikitis, Maria I. Argyropoulou and Athina C. Tsili

Cancers 2025, 17(19), 3220; https://doi.org/10.3390/cancers17193220 - 2 Oct 2025

Cited by 1 | Viewed by 1040

Abstract

Background/Objectives: Germ Cell Neoplasia In Situ (GCNIS) is considered the precursor lesion for the majority of testicular germ cell tumors (TGCTs). The aim of this study was to evaluate whether first-order radiomics features derived from volumetric diffusion tensor imaging (DTI) metrics—specifically apparent diffusion coefficient (ADC) and fractional anisotropy (FA) histogram parameters—can detect GCNIS. Methods: This study included 15 men with TGCTs and 10 controls. All participants underwent scrotal MRI, including DTI. Volumetric ADC and FA histogram metrics were calculated for the following tissues: group 1, TGCT; group 2: testicular parenchyma adjacent to tumor, histologically positive for GCNIS; and group 3, normal testis. Non-parametric statistics were used to assess differences in ADC and FA histogram parameters among the three groups. Pearson’s correlation analysis was followed by ordinal regression analysis to identify key predictive histogram parameters. Results: Widespread distributional differences (p < 0.05) were observed for many ADC and FA variables, with both TGCTs and GCNIS showing significant divergence from normal testes. Among the ADC statistics, the 10th percentile and skewness (p = 0.042), range (p = 0.023), interquartile range (p = 0.021), total energy (p = 0.033), entropy and kurtosis (p = 0.027) proved the most significant predictors for tissue classification. FA_energy (p = 0.039) was the most significant fingerprint of the carcinogenesis among the FA metrics. These parameters correctly characterized 88.8% of TGCTs, 87.5% of GCNIS tissues and 100% of normal testes. Conclusion: Radiomics features derived from volumetric ADC and FA histograms have promising potential to differentiate TGCTs, GCNIS, and normal testicular tissue, aiding early detection and characterization of pre-cancerous lesions. Full article

(This article belongs to the Special Issue Updates on Imaging of Common Urogenital Neoplasms—2nd Edition)

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Review

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20 pages, 2202 KB

Open AccessReview

MRI and Endometrial Cancer After FIGO 2023—What’s New? A Narrative Review

by Marco Gennarini, Roberta Valerieva Ninkova, Valentina Miceli, Federica Curti, Sandrine Riccardi, Benedetta Gui, Stefania Rizzo, Aradhana M. Venkatesan, Stephanie Nougaret and Lucia Manganaro

Cancers 2026, 18(6), 1005; https://doi.org/10.3390/cancers18061005 - 20 Mar 2026

Viewed by 760

Abstract

Endometrial cancer (EC) is the most common gynaecologic malignancy in developed countries, and its diagnostic and prognostic framework has evolved substantially following the introduction of the 2023 FIGO staging system, which integrates molecular classification with clinicopathologic features. Both histopathologic features, such as lymphovascular space invasion (LVSI) and molecular subtype, including POLE mutation status, mismatch-repair deficiency, and p53-abnormal phenotype, are incorporated into the updated staging system, highlighting the importance of tumour biology in risk stratification. Accordingly, the value and contribution of MRI to patient management must extend beyond macroscopic assessment to support a more biologically driven approach. This narrative review synthesizes recent advances in MRI for EC, highlighting developments that improve diagnostic accuracy and align imaging with the molecular paradigm. Multiparametric MRI remains the reference standard for local staging, while emerging quantitative diffusion techniques provide microstructural biomarkers associated with tumor aggressiveness and prognostic features. The consistency of nodal staging has been enhanced by Node-RADS, a structured reporting system that integrates nodal morphology and configuration, with the goal of improving reproducibility and diagnostic performance over size-based assessment alone. Radiomics and artificial intelligence (AI) represent the most transformative frontier, enabling MRI to infer biological behaviours previously accessible only via histopathologic assessment. Radiomics and deep-learning models have demonstrated high accuracy in predicting LVSI, DMI, nodal metastasis, and molecular subtypes, offering non-invasive biomarkers aligned with FIGO 2023 prognostic categories. Together, these advances position MRI as a quantitatively enriched, biologically relevant tool that supports precision oncology in endometrial cancer. Full article

(This article belongs to the Special Issue Updates on Imaging of Common Urogenital Neoplasms—2nd Edition)

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