The Application of Ultrasound in the Pre-operative Evaluation of Cervical Cancer

Cervical cancer is a common gynecologic malignancy worldwide, ranking fourth for both incidence and mortality. Imaging and pathology assessments are incorporated in the revised 2018 International Federation of Gynecology and Obstetrics staging system for cervical cancer. The use of imaging techniques for pre-operative evaluation of cervical cancer has been increasing. Among imaging modalities for evaluating cervical cancer, ultrasound is more easily accessible, faster and more widely available than other options such as computed tomography or magnetic resonance imaging. Advanced technique in ultrasound, such as three-dimension ultrasound and contrast-enhanced ultrasound, have improved the clinical application of ultrasound in cervical cancer. Ultrasound may provide highly accurate information on detecting tumor presence and assessing local extent if performed by well-trained sonographers, as the experience level of readers is also critical for correct pre-operative staging and evaluation of treatment response. In the future, ultrasound imaging with the assistance of artificial intelligence will play an even greater role in management. This review aims to present the most updated applications of ultrasound in the pre-operative evaluation of cervical cancer.