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Diagnostics
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Imaging for the Diagnosis of Obstetric and Gynecological Diseases—2nd Edition
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Imaging for the Diagnosis of Obstetric and Gynecological Diseases—2nd Edition

A Special Issue of Diagnostics (ISSN 2075-4418) belonging to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 31 July 2027 | Viewed by 10137

Editor

Dr. Nicolae Gica

E-Mail Website
Guest Editor
Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
Interests: gynecology; gynecologic oncology; laparoscopy; endometriosis and fertility preservation in women with cancer
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We invite you and your research group to submit an article to our Special Issue entitled “Imaging for the Diagnosis of Obstetric and Gynecological Diseases—2nd Edition”. This is the second volume of this Special Issue; we published more than five papers in the first volume. For more details, please visit the following webpage:

https://www.mdpi.com/journal/diagnostics/special_issues/1CR61574P8

Imaging methods for the diagnosis of obstetric and gynecological diseases involve the use of various imaging techniques, such as ultrasound, MRI, and CT scans, in order to assess conditions related to women or fetal diseases. These techniques are often used in daily medical activities and, for this reason, our aim is to collect interesting and educational papers on imaging related to our field. Additionally, imaging plays a crucial role in pregnancy monitoring, fetal development evaluation, and diagnosing other conditions. The accurate interpretation of imaging results is essential in guiding appropriate treatment and management strategies for patients with obstetric and gynecological diseases.

Dr. Nicolae Gica
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 short 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-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics 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 2600 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

  • diagnosis
  • imaging
  • gynecology and obstetrics
  • gynecological cancer
  • hysteroscopy
  • ovarian disease

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Published Papers (6 papers)

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Research

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13 pages, 8799 KB  
Article
Ovarian Metastasis from Invasive Lobular Carcinoma of the Breast: A 6-Case Series with Emphasis on Diagnostic Challenges and the Value of Biopsy
by Anqi Li, Lei Liu, Dingbao Chen, Yuan Peng and Feng Pan
Diagnostics 2026, 16(13), 2019; https://doi.org/10.3390/diagnostics16132019 - 28 Jun 2026
Viewed by 569
Abstract
Background: Invasive lobular carcinoma (ILC) of the breast has a unique metastatic pattern due to E-cadherin deficiency, with a predilection for peritoneal, gastrointestinal, and pelvic organ involvement. Ovarian metastasis from ILC is rare but can mimic primary ovarian cancer clinically and radiologically, [...] Read more.
Background: Invasive lobular carcinoma (ILC) of the breast has a unique metastatic pattern due to E-cadherin deficiency, with a predilection for peritoneal, gastrointestinal, and pelvic organ involvement. Ovarian metastasis from ILC is rare but can mimic primary ovarian cancer clinically and radiologically, leading to misdiagnosis and unnecessary radical surgery. This study aimed to summarize the imaging features of ovarian metastasis from ILC and analyze the causes of misdiagnosis, while highlighting the value of preoperative biopsy. Methods: Clinical and imaging data of six patients with pathologically confirmed ovarian metastasis from ILC were retrospectively analyzed. All six patients were female (age range 33–65 years), had a history of breast cancer (ILC subtype), and were found to have ovarian masses either during follow-up or at initial diagnosis. Imaging findings of the ovaries, peritoneum, and ascites were analyzed and compared with initial clinical diagnoses and pathological results. Results: Among the six patients, five were initially clinically misdiagnosed as having primary ovarian cancer and underwent unnecessary total hysterectomy with bilateral salpingo-oophorectomy. One patient (case 6) was correctly diagnosed via percutaneous biopsy of the omentum and skin nodules, which confirmed metastatic ILC, thereby avoiding unnecessary gynecological surgery. Imaging findings: All six patients had bilateral ovarian masses, appearing as solid or cystic-solid lesions. Peritoneal changes were observed in four cases. Ascites was present in five cases. Laboratory findings showed marked variability in CA125 levels (normal in three cases, elevated in three cases). Immunohistochemistry confirmed breast origin in all cases (GATA3+, PAX8−, E-cadherin−). In case 6, after four cycles of chemotherapy (albumin-bound paclitaxel + carboplatin + bevacizumab), follow-up CT demonstrated significant reduction in ovarian masses and regression of peritoneal and omental lesions. Conclusions: Ovarian metastasis from ILC is easily misdiagnosed as primary ovarian cancer without histologic confirmation, leading to unnecessary radical surgery. However, as demonstrated in case 6, percutaneous biopsy of accessible metastatic sites (omentum, peritoneum, or skin nodules) can establish the correct diagnosis and guide systemic therapy, thereby avoiding unnecessary surgery. In case 6, the ILC ovarian metastasis showed a favorable response to chemotherapy, but this single-case finding requires cautious interpretation as ILC is generally considered less chemosensitive than invasive ductal carcinoma. In patients with a history of breast cancer or with suspected metastatic disease, ILC metastasis should be included in the differential diagnosis of ovarian masses. Full article
(This article belongs to the Special Issue Imaging for the Diagnosis of Obstetric and Gynecological Diseases—2nd Edition)
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13 pages, 4194 KB  
Article
Diagnostic Performance of Saline Infusion Sonography with Color Doppler Flow (SIS-CF) for Assessing Tubal Patency: A Prospective Cohort Study
by Pantana Bangsomboon, Worashorn Lattiwongsakorn, Tawiwan Panthasri, Ubol Saeng-anan, Usanee Sanmee, Natnita Mattawanon and Natpat Jansaka
Diagnostics 2026, 16(9), 1287; https://doi.org/10.3390/diagnostics16091287 - 24 Apr 2026
Viewed by 1139
Abstract
Background/Objectives: Accurate evaluation of fallopian tube patency is an essential step in infertility assessment. This study investigated the diagnostic capability of saline infusion sonography combined with color Doppler flow (SIS-CF), using laparoscopic chromopertubation as the comparator method. Methods: A prospective diagnostic [...] Read more.
Background/Objectives: Accurate evaluation of fallopian tube patency is an essential step in infertility assessment. This study investigated the diagnostic capability of saline infusion sonography combined with color Doppler flow (SIS-CF), using laparoscopic chromopertubation as the comparator method. Methods: A prospective diagnostic accuracy study was conducted between January and November 2025 at the Infertility Unit, Chiang Mai University Hospital, Thailand. Women requiring laparoscopic assessment for infertility evaluation or preconception investigation were consecutively enrolled. Each participant underwent SIS-CF immediately before laparoscopic chromopertubation within the same operative session. Primary outcomes included diagnostic indices for tubal patency. Secondary outcomes included procedural duration and perioperative safety. Results: Forty-four women (88 fallopian tubes) were included. SIS-CF demonstrated sensitivity of 89.4% (95% CI 78.1–95.9) and specificity of 95.5% (95% CI 77.2–99.9). Positive and negative predictive values were 98.3% and 75.0%, respectively. Likelihood ratios were 19.65 (positive) and 0.11 (negative), with overall accuracy of 90.9% (95% CI 82.9–95.8). Median procedure duration was 5.7 min for SIS-CF and 3.0 min for laparoscopic chromopertubation. No adverse events were recorded. Conclusions: SIS-CF demonstrated favorable diagnostic characteristics for evaluation of tubal patency. The technique provided functional information regarding tubal status while maintaining a minimally invasive profile. Further investigation is warranted to determine its role within routine infertility workups. Full article
(This article belongs to the Special Issue Imaging for the Diagnosis of Obstetric and Gynecological Diseases—2nd Edition)
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16 pages, 2115 KB  
Article
MRI for Acute Pelvic Pain in Pediatric Females After Inconclusive Ultrasound: Diagnostic Performance of Non-Contrast-Enhanced and Contrast-Enhanced Protocols
by Gabriele Masselli, Giacomo Bonito, Laura Corso, Silvia Gigli, Lucia Malzone and Paolo Ricci
Diagnostics 2026, 16(6), 912; https://doi.org/10.3390/diagnostics16060912 - 19 Mar 2026
Viewed by 571
Abstract
Background/Objectives: Acute pelvic pain in pediatric female patients is a common presentation in the emergency setting and poses significant diagnostic challenges. Ultrasonography is the first-line imaging modality, but a substantial proportion of examinations remain inconclusive. Magnetic resonance imaging (MRI) is increasingly used [...] Read more.
Background/Objectives: Acute pelvic pain in pediatric female patients is a common presentation in the emergency setting and poses significant diagnostic challenges. Ultrasonography is the first-line imaging modality, but a substantial proportion of examinations remain inconclusive. Magnetic resonance imaging (MRI) is increasingly used as a second-line modality in this context; however, evidence comparing the diagnostic performance of non-contrast-enhanced and contrast-enhanced MRI protocols in pediatric patients remains limited. The aim of this study was to assess the diagnostic accuracy of MRI in pediatric females with acute pelvic pain after inconclusive ultrasonography and to compare non-contrast-enhanced and contrast-enhanced MRI protocols. Methods: This single-center observational study included pediatric female patients presenting with acute pelvic pain who underwent MRI after inconclusive ultrasonography. MRI examinations were performed using a standardized protocol including non-contrast-enhanced sequences and diffusion-weighted imaging. Administration of contrast material was determined by the attending radiologist according to clinical indications. Three radiologists with different levels of experience independently reviewed all examinations in two separate reading sessions (without and with contrast). Diagnostic performance, interobserver and intraobserver agreement, diagnostic confidence, and examination duration were assessed using a composite clinical reference standard. Results: Eighty-eight patients (mean age, 13.5 years; range, 7–17 years) were included. MRI identified a specific cause of acute pelvic pain in 60 patients (68.2%), with gynecological conditions accounting for 75.0% of positive findings. Hemorrhagic ovarian cysts and adnexal torsion were the most frequent diagnoses. Both non-contrast-enhanced and contrast-enhanced MRI demonstrated high diagnostic accuracy across all readers, with no statistically significant differences in sensitivity or specificity between protocols (p > 0.05). Contrast-enhanced MRI was associated with higher diagnostic confidence for all readers (p < 0.001) but longer examination times. Conclusions: MRI is a reliable second-line imaging modality for evaluating acute pelvic pain in pediatric female patients after inconclusive ultrasonography. Non-contrast-enhanced MRI combined with diffusion-weighted imaging provides robust diagnostic performance in most cases, while contrast-enhanced MRI may be reserved for selected equivocal cases. Full article
(This article belongs to the Special Issue Imaging for the Diagnosis of Obstetric and Gynecological Diseases—2nd Edition)
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Review

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23 pages, 919 KB  
Review
Mayer–Rokitansky–Kuster–Hauser Syndrome: From Radiological Diagnosis to Further Challenges—Review and Update
by Calin Schiau, Csaba Csutak, Anca Ileana Ciurea, Roxana Pintican, Ioana-Teofana Dulgheriu and Simona Manole
Diagnostics 2026, 16(1), 138; https://doi.org/10.3390/diagnostics16010138 - 1 Jan 2026
Cited by 1 | Viewed by 5998
Abstract
Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome encompasses a range of Müllerian duct anomalies characterized by congenital absence of the uterus and the upper two-thirds of the vagina in young women who otherwise exhibit normal endocrine function and a 46,XX karyotype. MRKH syndrome can occur in an [...] Read more.
Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome encompasses a range of Müllerian duct anomalies characterized by congenital absence of the uterus and the upper two-thirds of the vagina in young women who otherwise exhibit normal endocrine function and a 46,XX karyotype. MRKH syndrome can occur in an isolated form (type I) or in association with other congenital anomalies (type II or MURCS association), which may include renal, vertebral, auditory, and cardiac defects. It represents one of the most frequent causes of primary amenorrhea, affecting approximately 1 in every 4000–5000 women. MRKH syndrome often remains undiagnosed until a patient presents with primary amenorrhea, despite normal development of secondary sexual characteristics. Both genetic and non-genetic factors have been proposed as contributing to abnormal embryonic development, although the exact etiopathogenesis remains unclear. Imaging plays a key role in the evaluation of genital tract anomalies, allowing non-invasive and comprehensive assessment. Alongside physical examination and pelvic ultrasound, pelvic MRI is essential for identifying the presence of rudimentary uterine tissue. MRKH syndrome can have profound and lasting psychological impacts, making it essential for patients and their families to receive counseling both before and throughout treatment. A range of therapeutic options—both surgical and non-surgical—have been proposed for managing MRKH syndrome. Vaginal dilation remains the first-line treatment, as it offers high success rates with minimal risk of complications. Vaginoplasty is considered a second-line option for patients who do not respond to dilation therapy. Additionally, uterine transplantation and gestational surrogacy provide opportunities for women with MRKH syndrome to achieve biological motherhood. This review provides an updated overview of Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome, encompassing its etiological, clinical, diagnostic, psychological, therapeutic, and reproductive aspects. We also present a case involving a 19-year-old woman with MRKH syndrome who presented with primary amenorrhea, highlighting the crucial role and advantages of MRI in diagnosis, differential assessment, and treatment planning. Full article
(This article belongs to the Special Issue Imaging for the Diagnosis of Obstetric and Gynecological Diseases—2nd Edition)
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Other

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5 pages, 996 KB  
Interesting Images
Pelvic Actinomycosis Mimicking Gynecologic Malignancy: CT and Histopathologic Correlation
by Jia Yi Kow and Yi-Wen Su
Diagnostics 2026, 16(16), 2586; https://doi.org/10.3390/diagnostics16162586 - 15 Aug 2026
Viewed by 222
Abstract
A healthy 65-year-old postmenopausal woman with a 15-year history of copper intrauterine device use presented to the emergency room with several days of lower abdominal pain and diarrhea. Laboratory testing revealed leukocytosis (white blood cell count, 26.15 × 103/µL) and elevated [...] Read more.
A healthy 65-year-old postmenopausal woman with a 15-year history of copper intrauterine device use presented to the emergency room with several days of lower abdominal pain and diarrhea. Laboratory testing revealed leukocytosis (white blood cell count, 26.15 × 103/µL) and elevated C-reactive protein (19.81 mg/dL). Contrast-enhanced computed tomography demonstrated multiple cystic and heterogeneous abdominopelvic lesions, including extension across the abdominal wall fascia and muscles, with involvement of the uterus and urinary bladder, raising suspicion for advanced gynecologic malignancy with peritoneal dissemination. Tumor markers were within normal limits. Persistent lower abdominal pain and inflammatory markers without fever and negative blood culture after a week of empirical antibiotics (Flomoxef Sodium 2000 mg) prompted exploratory laparotomy to evaluate for possible ovarian malignancy or abscess. Total hysterectomy, right salpingo-oophorectomy, partial excision of the abdominal abscess, and drainage of the left ovarian abscess were performed. Histopathology later confirmed the diagnosis of diffuse pelvic actinomycosis. The patient recovered after surgical drainage and antibiotics penicillin G for 4 weeks, followed by doxycycline (200 mg) twice daily for 3 months. This case highlights the important radiologic features of pelvic actinomycosis mimicking gynecologic malignancy, particularly in women with prolonged intrauterine device use and the management in refractory pelvic actinomycosis. Full article
(This article belongs to the Special Issue Imaging for the Diagnosis of Obstetric and Gynecological Diseases—2nd Edition)
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11 pages, 1625 KB  
Interesting Images
HPV16-Positive Pelvic Nodal Squamous Cell Carcinoma with No Detectable Cervical Malignancy
by In Sun Hwang, Su Jeong Lee, Chan Joo Kim, Jin-Hwi Kim and Kwangil Yim
Diagnostics 2026, 16(5), 787; https://doi.org/10.3390/diagnostics16050787 - 6 Mar 2026
Viewed by 903
Abstract
Isolated pelvic nodal metastasis from carcinoma of unknown primary origin (CUP) is rare. Evaluation should prioritize gynecological and anorectal sites based on pelvic lymphatic drainage. Although spontaneous regression of these primary lesions is exceptional, regressed lesions can present as CUP, necessitating diagnostic caution. [...] Read more.
Isolated pelvic nodal metastasis from carcinoma of unknown primary origin (CUP) is rare. Evaluation should prioritize gynecological and anorectal sites based on pelvic lymphatic drainage. Although spontaneous regression of these primary lesions is exceptional, regressed lesions can present as CUP, necessitating diagnostic caution. Here, we report the case of a 40-year-old woman with a solitary, intensely fluorodeoxyglucose F-18 avid left obturator lymph node and a subtle endocervical abnormality on pelvic magnetic resonance imaging. Loop electrosurgical excision revealed a Nabothian cyst only. Excisional nodal biopsy by polymerase chain reaction revealed metastatic squamous cell carcinoma with diffuse block-type p16 and human papillomavirus (HPV) 16. Considering the potential for a primary cervical tumor along the obturator drainage pathway, the patient underwent hysterectomy with pelvic lymph node dissection. No residual invasive carcinoma was found; however, HPV16 was detected in the cervix with a low-grade squamous intraepithelial lesion, supporting a regressed cervical focus. She received adjuvant cisplatin-based chemoradiotherapy and has remained disease-free for 56 months. This case highlights the diagnostic value of integrating lymphatic anatomy with the molecular profile of HPV. Cervical squamous cell carcinoma rarely regresses and presents solely as an isolated nodal disease. Full article
(This article belongs to the Special Issue Imaging for the Diagnosis of Obstetric and Gynecological Diseases—2nd Edition)
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