Acute pelvic pain (APP) requires urgent medical evaluation and treatment. Differential diagnosis of APP is broad, including a variety of gynecologic and non-gynecologic/ urinary, gastrointestinal, vascular and other entities. Close anatomical and physiological relations of pelvic structures, together with similar clinical presentation of different disorders and overlapping of symptoms, especially in the emergency background, make the proper diagnosis of APP challenging. Imaging plays a crucial role in the fast and precise diagnosis of APP. Ultrasonography is the first-line imaging modality, often accompanied by CT, while MRI is utilized in specific cases, using short, tailored protocols. Recognizing the cause of APP in females is a challenging task, due to the wide spectrum of possible origin and overlap of their imaging features. Therefore, the radiologist has to be familiar with the possible causes of APP, and, relying on clinical presentation, together with laboratory findings, choose the best imaging strategy in order to establish a fast and accurate diagnosis.

Introduction. During the period from 1993 - 2013, 175 women with invasive cervical cancer underwent radical hysterectomy sec. Wertheim-Meigs at the Department of Gynecology and Obstetrics, Clinical Center of Vojvodina in Novi Sad. Indications for radical hysterectomy comprise histopathologically confirmed invasive cervical cancer in stages I B 1 - II B according to the International Federation of Gynecology and Obstetrics. Material and Methods. Stage of the disease or extent of the disease spread to the adjacent structures was assessed in accordance with the International Federation of Gynecology and Obstetrics staging system from 2009. Exclusion criteria were all other stages of this disease: I A and stages higher than II B, as well as the absence of definite histological confirmation of the cervical cancer (primary endometrial or vaginal cancer which infiltrates the uterine cervix). Prior the operation, the following had to be done: the imaging of pelvis and abdomen, chest X-ray in two directions, electrocardiography, internist and anesthesiological examination. Results. The patients’ age ranged from 24-79 years (x : 46 years), and the operation duration was 120-300 minutes (x : 210 min.). Stage I B 1 was found in 64.6% of operated patients, 14.8% of the patients were in stage I B 2, 9.1% were in stage II A and 11.4 % were in stage II B. Blood loss during the operation ranged from 50-800 ml (on average 300 ml), and the number of removed lymph nodes per operation was 14-75 (x : 32). Intraoperative and postoperative complications developed in 6.8% of and 17.7% of patients, respectively. Recurrence was reported in 22 (12.5%) patients, most often in paraaortic lymph nodes (3.4%) and parametria (2.8%), while the overall 5-year survival rate was 87% until 2008. Concluision. Wertheim-Meigs radical hysterectomy is a basic surgical technique for the treatment of initial stages of invasive cervical cancer.

Introduction. Ovarian cancer is an intra-abdominal, chemosensitive, chronic disease and according to current protocols, it is primarily treated with surgery followed by adjuvant chemotherapy. In Serbia, 820 cases of ovarian cancer are newly diagnosed annually. The aim of the study is to present the results of surgical treatment in 304 patients with ovarian cancer, treated during a 15-year period (2003 - 2017) at the Clinic of Gynecology and Obstetrics, Clinical Center of Vojvodina in Novi Sad. Material and Methods. Before the operation, clinical, gynecological, ultrasonography examination and analysis of cancer antigen 125 blood concentrations were performed in all patients. Based on basic diagnostics, additional pelvic, abdominal and thoracic computed tomography or magnetic resonance imaging studies, together with colonoscopy if needed, were performed. The selection of the type and extent of surgical procedure was based on intraoperative assessment of the stage of disease, intraoperative histopathological confirmation of ovarian cancer, wish for fertility preservation and general patient?s condition. Exclusion criteria were histopathologically confirmed benign or borderline ovarian tumors, i. e. absence of cancer in the final microscopic specimen. Results. The patients? age ranged from 19 - 88 years, with a median of 53.4 years. According to the International Federation of Gynecology and Obstetrics staging, most patients had stage III - 98 (33.1%) and epithelial ovarian cancer - 240 (84.2%). The most common surgical procedures were hysterectomy with bilateral adnexectomy and omentectomy, whereas cytological analysis was performed in 138 (45.4%) treated patients. Complications were recorded in 13 (4.3%) operated patients with inflammation and wound seroma being the most common (4 patients - 1.3% of cases). Conclusion. Ovarian cancer treatment is planned individually, depending on the stage of the disease, histological tumor type, patient?s general condition, wish for fertility-sparing treatment and technical capacity of the institution where the treatment is performed.

Background/Aim. Breast cancer is a leading global health concern. Contrast-enhanced mammography (CEM) presents a promising advancement in early breast cancer detection, excelling in sensitivity, specificity, and cost-effectiveness. The aim of the study was to assess the overall diagnostic efficacy of CEM in breast cancer screening, particularly in distinguishing benign from malignant lesions in dense breasts. Methods. A two-year retrospective study was conducted at the Center for Radiology, including a total of 279 women undergoing CEM following standard mammography. Results. CEM demonstrated high sensitivity (92.4%), specificity (75.1%), and a noteworthy negative predictive value of 97.0%, significantly reducing unnecessary biopsies. Conclusion. CEM is a valuable screening tool, offering enhanced diagnostic capabilities and the potential to reduce the number of unnecessary biopsies. It is particularly beneficial for patients with dense breasts or inconclusive traditional mammography results.

Background/Aim. Multislice computed tomography (MSCT) has triggered considerable changes in uroradiological imaging. The aim of this study was to establish the place of MSCT urography (MSCTU) in comparison with intravenous urography (IVU) and to determine the sensitivity and specificity of MSCT in the evaluation of urothelial abnormalities. Methods. This prospective study included 120 patients with a high clinical suspicion of urinary tract diseases divided into two groups. The group I consisted of 60 patients with macroscopic hematuria, bladder carcinoma and malignant pelvic tumors after radiotherapy or operation. They underwent both IVU and MSCTU. The group II included 60 patients (? 40 years old) with retroperitoneal and malignant pelvic tumors, complicated pyelonephritis, microscopic hematuria, acute urinary tract obstruction (without visible calculi on unenhanced scans), and they were submitted to computed tomography with additional scan phase enabling MSCTU. Results. Compared with IVU, MSCTU is more sensitive for the detection of urinary tract diseases (parenchymal changes, renal tumors, urolithiasis, fibrosis) and extraurinary processes. MSCTU is more specific than IVU for renal parenchymal abnormalities, tumors of the excretory system, urolithiasis, bladder tumors, fibrosis and extraurinary diseases. MSCTU is equally sensitive, but more specific for hydronephrosis compared to MSCT. The diagnosis made by the use of MSCTU in patients with macroscopic and microscopic hematuria and with obstruction not caused by stones, perfectly comply with operative findings and histological diagnosis. Conclusion. The obtained results support MSCTU to be the modality of choice in the diagnostic algorithm of patients with macroscopic hematuria and in the evaluation of microscopic hematuria and unexplained obstruction of the urinary tract. The only remaining role for IVU in our institution is imaging of the upper urinary tract in patients with hematuria under the age of 40.