The role of MRI in the staging of vaginal carcinoma is not well defined. More studies are required, but are difficult due to the rarity of the tumour. In most cases initial management decisions are based upon clinical examination. However, clinical examination may be inaccurate and ideally MRI should also be performed as it may detect more advanced tumour than is suspected clinically and lead to alterations in management. MRI has an important role in selection of patients and surgical planning prior to pelvic exenteration.
The likelihood of pelvic lymph node metastases, determined by MRI or CT, will affect radiotherapy planning. MRI is useful in detecting tumour recurrence, particularly in patients with vaginal stenosis secondary to radiotherapy who cannot be adequately examined clinically. In addition, in patients with symptoms suggestive of colovaginal or vesicovaginal fistula, MRI is the imaging investigation of choice for delineation of the extent of the fistula and for surgical planning.
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