Advancing Women's Health, the Radiologist's Way: A Guide to Optimizing Imaging for Benign Gynecological Conditions

Rupa Renganathan, DMRD, DNB, FRCR, EBBI

I am pleased to release the first edition of the special issue on gynecological imaging. This first issue emphasizes the imaging of benign gynecological conditions, highlighting recent updates, standardized terminology, and the roles of imaging and image-guided interventions in the management of benign gynecological pathologies, including congenital anomalies. I would like to thank all the authors who contributed to this edition.

Müllerian anomalies include a variety of abnormalities and are often associated with primary amenorrhea, infertility, endometriosis, and obstetric complications. Classifications systems proposed by the American Society for Reproductive Medicine (ASRM) and the European Society of Human Reproduction and Embryology are frequently used for categorization. Tulika Singh et al's review[1] examines key aspects, including embryology, imaging methods, and classification systems, and offers guidance on evaluating uterine anomalies using structured reports and checklists. Accurate diagnosis and understanding of these anomalies and their associations facilitate personalized treatment and improve reproductive outcomes.

Infertility is a widespread issue with significant psychosocial impacts beyond its medical causes. Imaging is crucial for diagnosis and management. Javalgi et al's review[2] highlights the causes, techniques, and imaging features of pathologies identified across multiple modalities. Hysterosalpingography (HSG) and ultrasonography (USG) are standard initial tests used to assess tubal patency and structural abnormalities, while Fertiliscan integrates three-dimensional ultrasonography (3D USG) and saline infusion sonography (SIS) for a comprehensive approach. Recent advances in contrast-enhanced SIS and magnetic resonance HSG expand radiologists' capabilities and are discussed in detail.

Acute abdominal pain is common and challenging, particularly in women of reproductive age, in whom gynecological causes are frequent. Delayed diagnosis can lead to serious complications, emphasizing the need for diagnostic precision. Subramaniam et al's article[3] reviews gynecological emergencies, their clinical presentation, and associated imaging findings, providing an overview of key clinical signs and imaging features.

Abnormal uterine bleeding affects about one-third of women at some point in their lives. It may have structural or non-structural causes, often occurring in combination. FIGO (International Federation of Gynecology and Obstetrics) introduced the PALM-COEIN classification system in 2011 to standardize the assessment of abnormal uterine bleeding (AUB). Renganathan et al[4] discuss definitions and terminology, point out the roles of imaging and diagnostic tools in categorizing the causes of AUB, and provide a diagnostic algorithm and an imaging checklist.

The incidence of endometriosis is rising, and imaging plays a key role in mapping lesions and guiding surgical planning. The review article by Gosh et al,[5] discusses the various sites, types, and complications of endometriosis, along with their surgical implications.

Symptoms of pelvic floor dysfunction are often overlooked. Because pelvic floor weakness can involve multiple compartments, a comprehensive assessment is essential before surgery. Eapen et al's review[6] covers pelvic anatomy and a stepwise MRI-based evaluation, recommending the combined use of fluoroscopic defecography, dynamic cystocolpoproctography, and dynamic MRI. It also emphasizes correlating symptoms with imaging findings to improve surgical outcomes.

Technological advances in radiology have transformed medical practice, making image-guided procedures the standard due to their accuracy and minimally invasive nature. Bandey et al[7] review both vascular and non-vascular, minimally invasive, image-guided interventions used for diagnosis and treatment in gynecology.

I am confident that these review articles will aid each of you in your daily clinical practice. The imaging algorithms and checklists are practical tools that will support your routine work and contribute positively to women's health worldwide.

Conflict of Interest

None declared.

• References

• 1 Singh T, Sri G, Singla V. et al. Müllerian anomalies: revisited. J Gastrointestinal Abdominal Radiol 2026; 9 (01) 3-17
• 2 Javalgi AA, Bagri N, Bhayana A. et al. Imaging approach to infertility. J Gastrointestinal Abdominal Radiol 2026; 9 (01) 18-33
• 3 Subramaniam P, Renganathan R, Singh T. et al. Imaging in acute female pelvic conditions: a focus on diagnostic precision and clinical evaluation. J Gastrointestinal Abdominal Radiol 2026; 9 (01) 34-53
• 4 Renganathan R, Subramaniam P, Palanisamy S. et al. Imaging in abnormal uterine bleeding: key insights for enhancing radiologists' expertise. J Gastrointestinal Abdominal Radiol 2026; 9 (01) 54-68
• 5 Ghosh S, Mann K, Nakrour N. et al. Endometrioma: a comprehensive review of its varied presentations, complications, and impact on patient management. J Gastrointestinal Abdominal Radiol 2026; 9 (01) 69-89
• 6 Eapen A, Lakhani A, Hiriyanna S. et al. Imaging of pelvic floor dysfunction. J Gastrointestinal Abdominal Radiol 2026; 9 (01) 90-100
• 7 Banday SA, Gopinathan K, Poyyamoli S. et al. Vascular and nonvascular interventions in gynecology. J Gastrointestinal Abdominal Radiol 2026; 9 (01) 101-114

Publication History

Article published online:
26 February 2026