Ovarian cancer is the gynecological cancer with the highest mortality. In most cases it is diagnosed at an advanced stage, when the tumor is already spread throughout the peritoneum. The only prognostic factor that improves survival in patients with ovarian cancer is complete cytoreduction (R0). To assess whether this resection is feasible, the most effective imaging study, with the best correlation with the results of surgery, is whole-body MRI with diffusion weighted sequences (WB-DW-MRI). The aim of this work is to provide a practical and complete guide so that any radiologist can confidently perform a study of good diagnostic quality as well as a complete report that contains all the relevant information so that an appropriate decision can be made on the management of the patient.

Hematometrocolpos is the accumulation of blood products within uterine cavity and vagina because of anatomical outflow obstruction to menstrual blood passage. Vaginal septum is an important aetiology of obstruction amenable to surgical correction, among other causes such as imperforate hymen and distal vaginal atresia.However, the visualisation of vaginal septum in conventional MRI or ultrasound can be challenging due to lack of contrast between the septum and adjacent vaginal soft tissue. Gel instillation is used to achieve vaginal distension for better delineation for vaginal septum for surgical planning. We present companion cases of pelvic MRI assessment of vaginal septum, with and without vaginal gel instillation, to illustrate the optimized visualisation of vaginal septum with gel usage. Surgical and pathological correlation regarding fibrous nature of vaginal septum characteristics were addressed.

References: EAU Guidelines. Edn. presented at the EAU Annual Congress Milan 2023. ISBN 978-94-92671-19-6 Park BK, et al. Thermal Ablation for Renal Cell Carcinoma: Expert Consensus from the Asian Conference on Tumor Ablation. Korean J Radiol. 2021 Sep;22(9):1490-1496 Finelli, A., et al. Small Renal Mass Surveillance: Histology-specific Growth Rates in a Biopsycharacterized Cohort. Eur Urol, 2020. 78: 460 Amaral, B.S., et al. Renal Tumor Biopsy: Rationale to Avoid Surgery in Small Renal Masses. Curr Urol Rep, 2021. 22: 46

Recognizing the metastatic potential of RCC and leveraging timely imaging for evaluation is paramount for informed clinical decisions, appropriate treatment and outcomes. Thereby, it is critical that radiologists be aware of potential sites of RCC metastasis, aiding its distinction from primary lesions.