Gel Sonovaginography: A New Way of Evaluating a Variety of Local Vaginal and Cervical Disorders

Vaginosonography versus MRI in Pre-Treatment Evaluation of Early-Stage Cervical Cancer: An Old Tool for a New Precision Approach?

This study aims to analyze the sensitivity of vaginosonography (VGS) and magnetic resonance imaging (MRI) in the preoperative local evaluation of early-stage cervical cancers and to assess their accuracy in the detection of tumors, size of the lesions and stromal invasion by comparing them with the final histopathology report. This single-center study included 56 consecutive patients with cervical cancer who underwent VGS and MRI from November 2012 to January 2021. VGS significantly overestimated the lesion size by 2.7 mm (p = 0.002), and MRI underestimated it by 1.9 mm (p = 0.11). Both MRI and VGS had a good concordance with the pathology report (Cohen’s kappa of 0.73 and 0.81, respectively). However, MRI had a false-negative rate (38.1%) that was greater than VGS (0%) in cases of cervical tumor size <2 cm. We found a good concordance between histology and VGS in the stromal infiltration assessment, with 89% sensitivity (95% CI 0.44−0.83) and 89% specificity (95% CI 0.52−0.86). VGS is a simple, inexpensive, widely available, and fast execution method that can complement ultrasound in particular cases and show a good correlation with MRI in the assessment of tumor dimensions, with a better performance in detecting small tumors (<2 cm).

The Application of Sonovaginography for Implementing Ultrasound Assessment of Endometriosis and Other Gynaecological Diseases

Sonovaginography is a way of assessing gynaecological diseases that can be described as cheap yet accurate and non-invasive. It consists of distention of the vagina with ultrasound gel or saline solution while performing transvaginal sonography to clearly visualize and assess a host of local cervical, as well as any vaginal, disorders. With endometriosis being a steadily growing gynaecological pathology affecting 8-15% of women of fertile age, transvaginal sonography (TVS) can be considered as one of the most accurate and comprehensive imaging techniques in its diagnosis. Nevertheless, the accuracy may vary depending on scan sites. The purpose of this narrative review is to assess the performance of sonovaginography in detecting endometriosis in those sites where TVS has a low sensitivity.