EP24.09: Ultrasound assessment of the pelvic sidewall: a methodological consensus

The aim of this article is to provide a systematic methodology for ultrasonographic evaluation of the pelvic sidewall, based on a multicentric consensus. The assessment of the structures within this anatomical region is a crucial component in the evaluation of metastatic spread of gynecological malignancies, as well as in the precise definition of benign gynecological conditions causing pelvic pain. A sound knowledge of the main anatomical structures is of the utmost importance to perform a proper sonographic evaluation of the pelvic sidewall. Based on this assumption, all the sonographic landmarks are anatomically described, and their methodological evaluation is provided step by step with the visual support of graphics and videos. Five categories of fundamental anatomical structures have been identified and extensively described (muscles, vessels, lymph nodes, nerves and ureters). Transvaginal ultrasound has proven to be a feasible and adequate technique for the depiction of each identified anatomical landmark, pertaining to those categories. The capacity to accurately assess the pelvic sidewall using a standardised transvaginal approach improves detection and diagnosis of non-gynecological pathologies that may mimic gynecological tumours, reducing the risk of unnecessary and even harmful interventions. Furthermore, it plays a key role in completing the staging of malignant gynecologic conditions. Ultrasound could therefore represent a future alternative to MRI in the preoperative evaluation of lesions affecting the pelvic sidewall, if performed by expert sonographers. Funding: This research was supported by the Ministry of Health of the Czech Republic (NU21-03-00461) Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.