Abstract
Noninvasive lymph node staging has been a challenge in oncology for many years since it is the first route of tumor metastasis, determining tumor treatment and prognosis. In gynecologic malignancies, lymph nodes are surgically collected in a systematic way and histopathologically evaluated, which is the most sensitive approach to exclude lymphatic metastases. Lymph node dissection results in longer operating times, more peroperative blood loss and higher rates of postoperative complications, such as lymph cysts or lymphedema. Several imaging modalities have been tested for their diagnostic accuracy in lymph node visualization. Their performance is evaluated in this thorough review involving endometrial, ovarian, vulvar and cervical cancer. Finally, new noninvasive diagnostic imaging techniques are discussed.