Exploring Gynecological Pathology and Imaging

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: 28 February 2025 | Viewed by 9312

Special Issue Editor


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Guest Editor
Radiology Department, “G Criscuoli” Hospital, Sant’ Angelo dei Lombardi, Italy
Interests: imaging; diagnostic; breast imaging; breast prevention
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Special Issue Information

Dear Colleagues,

This Special Issue attempts to update our knowledge on the imaging and pathology of very common cancers (such as breast, ovarian, and endometrial cancer).

The diagnosis and treatment of gynecological cancer is an ever-evolving topic in tandem with technology and scientific developments.

The introduction of new diagnostic methods and the advances in current imaging and pathology tools allow the precise characterization of tumors before treatment is conducted, and new technologies such as artificial intelligence could allow individualized treatments and the prediction of prognosis.

We look forward to receiving manuscripts on the diagnosis, treatment, and prognosis of patients with gynecological cancers.

Dr. Graziella Di Grezia
Guest Editor

Manuscript Submission Information

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Keywords

  • gynecological pathology
  • pelvic imaging
  • cervical cancer
  • ovarian masses
  • uterine fibroids

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Published Papers (4 papers)

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Research

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13 pages, 265 KiB  
Article
The Diagnostic Accuracy of Electrical Impedance Spectroscopy-Assisted Colposcopy, HPV mRNA Test, and P16/Ki67 Immunostaining as CIN2+ Predictors in Greek Population
by Nikolaos Tsampazis, Eleftherios Vavoulidis, Chrysoula Margioula-Siarkou, Marianthi Symeonidou, Stergios Intzes, Alexios Papanikolaou, Konstantinos Dinas and Angelos Daniilidis
Diagnostics 2024, 14(13), 1379; https://doi.org/10.3390/diagnostics14131379 - 28 Jun 2024
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Abstract
Objective: To evaluate the diagnostic accuracy of Electrical Impedance Spectroscopy (EIS)-assisted colposcopy in detecting CIN2+ Greek women towards standalone colposcopy, HPV mRNA testing, and p16/Ki67 immunostaining. Methods: We conducted a cross-sectional observational study at the Cervical Pathology Clinic of the 2nd Obstetrics-Gynecology University [...] Read more.
Objective: To evaluate the diagnostic accuracy of Electrical Impedance Spectroscopy (EIS)-assisted colposcopy in detecting CIN2+ Greek women towards standalone colposcopy, HPV mRNA testing, and p16/Ki67 immunostaining. Methods: We conducted a cross-sectional observational study at the Cervical Pathology Clinic of the 2nd Obstetrics-Gynecology University Department of Hippokration Hospital Thessaloniki involving 316 patients from January 2022 to August 2023. All participants provided liquid-based cervical samples for cytology, HPV mRNA testing, and p16/Ki67 immunostaining. Main Outcome Measures: Subsequently, participants underwent both standalone colposcopy and EIS/ZedScan-assisted colposcopy, followed by cervical punch biopsies. Results: The incorporation of EIS significantly enhanced the sensitivity of colposcopy, increasing it from 54.17% to 100%, equivalent to that of HPV mRNA testing and p16/Ki67 immunostaining, while achieving a high specificity (95.45%). The specificities observed with EIS/ZedScan-assisted and standalone colposcopy were notably superior to those of HPV-related biomarkers (HPV mRNA test and p16/Ki67 immunostaining). When compared to standalone colposcopy, HPV mRNA testing, and p16/Ki67 immunostaining, EIS/ZedScan-assisted colposcopy demonstrated the most favorable combination of Positive and Negative Predictive Values, at 90.57% and 100%, respectively. The inclusion of EIS/ZedScan in colposcopy led to the detection of 44 additional cases of true CIN2+ (100% of the total CIN2+ confirmed histologically) that were missed by standalone colposcopy. This discovery suggests a 45.83% increase in the detection of CIN2+ cases. Conclusions: The integration of EIS with colposcopy has demonstrated effectiveness in detecting cervical lesions, resulting in a significant detection increase of CIN2+ cases while offering optimal levels of sensitivity, specificity, and predictive values for CIN2+ detection. Full article
(This article belongs to the Special Issue Exploring Gynecological Pathology and Imaging)

Review

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22 pages, 1279 KiB  
Review
Tailoring the Diagnostic Pathway for Medical and Surgical Treatment of Uterine Fibroids: A Narrative Review
by Gabriele Centini, Alberto Cannoni, Alessandro Ginetti, Irene Colombi, Matteo Giorgi, Giorgia Schettini, Francesco Giuseppe Martire, Lucia Lazzeri and Errico Zupi
Diagnostics 2024, 14(18), 2046; https://doi.org/10.3390/diagnostics14182046 - 14 Sep 2024
Abstract
Uterine leiomyomas are the most common benign uterine tumors in women and are often asymptomatic, with clinical manifestation occurring in 20–25% of cases. The diagnostic pathway begins with clinical suspicion and includes an ultrasound examination, diagnostic hysteroscopy, and, when deemed necessary, magnetic resonance [...] Read more.
Uterine leiomyomas are the most common benign uterine tumors in women and are often asymptomatic, with clinical manifestation occurring in 20–25% of cases. The diagnostic pathway begins with clinical suspicion and includes an ultrasound examination, diagnostic hysteroscopy, and, when deemed necessary, magnetic resonance imaging. The decision-making process should consider the impairment of quality of life due to symptoms, reproductive desire, suspicion of malignancy, and, of course, the woman’s preferences. Despite the absence of a definitive cure, the management of fibroid-related symptoms can benefit from various medical therapies, ranging from symptomatic treatments to the latest hormonal drugs aimed at reducing the clinical impact of fibroids on women’s well-being. When medical therapy is not a definitive solution for a patient, it can be used as a bridge to prepare the patient for surgery. Surgical approaches continue to play a crucial role in the treatment of fibroids, as the gynecologist has the opportunity to choose from various surgical options and tailor the intervention to the patient’s needs. This review aims to summarize the clinical pathway necessary for the diagnostic assessment of a patient with uterine fibromatosis, presenting all available treatment options to address the needs of different types of women. Full article
(This article belongs to the Special Issue Exploring Gynecological Pathology and Imaging)
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12 pages, 1008 KiB  
Review
Breast Imaging Physics in Mammography (Part II)
by Noemi Fico, Graziella Di Grezia, Vincenzo Cuccurullo, Antonio Alessandro Helliot Salvia, Aniello Iacomino, Antonella Sciarra, Daniele La Forgia and Gianluca Gatta
Diagnostics 2023, 13(23), 3582; https://doi.org/10.3390/diagnostics13233582 - 1 Dec 2023
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Abstract
One of the most frequently detected neoplasms in women in Italy is breast cancer, for which high-sensitivity diagnostic techniques are essential for early diagnosis in order to minimize mortality rates. As addressed in Part I of this work, we have seen how conditions [...] Read more.
One of the most frequently detected neoplasms in women in Italy is breast cancer, for which high-sensitivity diagnostic techniques are essential for early diagnosis in order to minimize mortality rates. As addressed in Part I of this work, we have seen how conditions such as high glandular density or limitations related to mammographic sensitivity have driven the optimization of technology and the use of increasingly advanced and specific diagnostic methodologies. While the first part focused on analyzing the use of a mammography machine from a physical and dosimetric perspective, in this paper, we will examine other techniques commonly used in breast imaging: contrast-enhanced mammography, digital breast tomosynthesis, radio imaging, and include some notes on image processing. We will also explore the differences between these various techniques to provide a comprehensive overview of breast lesion detection techniques. We will examine the strengths and weaknesses of different diagnostic modalities and observe how, with the implementation of improvements over time, increasingly effective diagnoses can be achieved. Full article
(This article belongs to the Special Issue Exploring Gynecological Pathology and Imaging)
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15 pages, 4638 KiB  
Review
Breast Imaging Physics in Mammography (Part I)
by Noemi Fico, Graziella Di Grezia, Vincenzo Cuccurullo, Antonio Alessandro Helliot Salvia, Aniello Iacomino, Antonella Sciarra and Gianluca Gatta
Diagnostics 2023, 13(20), 3227; https://doi.org/10.3390/diagnostics13203227 - 17 Oct 2023
Cited by 2 | Viewed by 4072
Abstract
Breast cancer is the most frequently diagnosed neoplasm in women in Italy. There are several risk factors, but thanks to screening and increased awareness, most breast cancers are diagnosed at an early stage when surgical treatment can most often be conservative and the [...] Read more.
Breast cancer is the most frequently diagnosed neoplasm in women in Italy. There are several risk factors, but thanks to screening and increased awareness, most breast cancers are diagnosed at an early stage when surgical treatment can most often be conservative and the adopted therapy is more effective. Regular screening is essential but advanced technology is needed to achieve quality diagnoses. Mammography is the gold standard for early detection of breast cancer. It is a specialized technique for detecting breast cancer and, thus, distinguishing normal tissue from cancerous breast tissue. Mammography techniques are based on physical principles: through the proper use of X-rays, the structures of different tissues can be observed. This first part of the paper attempts to explain the physical principles used in mammography. In particular, we will see how a mammogram is composed and what physical principles are used to obtain diagnostic images. Full article
(This article belongs to the Special Issue Exploring Gynecological Pathology and Imaging)
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