Newer diagnostic approaches to the evaluation of gynecologic malignancies.

The use of peritoneoscopy, lymphangiography, ultrasonography, computerized tomography, and thin-needle aspiration in the evaluation of gynecologic malignancies is discussed. Peritoneoscopy has made a large impact on the staging and follow-up of patients with ovarian cancer. Lymphangiography, combined more recently with ultrasonography or computerized tomography, appears to be especially useful in evaluating patients with cervical cancer for lymph node metastases outside the usual radiation treatment fields. Ultrasonography and computerized tomography are useful for evaluating masses for resectability and treatment response, planning radiation therapy, detecting metastases and ascites, and directing thin-needle aspiration of masses. Thin-needle aspiration techniques are now available which provide a means for sampling areas which were previously inaccessible except to open operative biopsy or where biopsy might result in serious complications.