Insights into endometrial cancer management: a comprehensive guide through multimodality imaging

Endometrial cancer is the most common gynecologic malignancy in developed countries, exhibiting significant heterogeneity in prognosis and management. This review highlights the critical role of multimodality imaging—including ultrasound, MRI, CT, and PET/CT—at every stage of care, from initial diagnosis and risk stratification to surgical planning, treatment selection, and surveillance. Imaging enables accurate tumor characterization, local and distant staging, and detection of nodal and peritoneal disease, but also significantly influences the choice between conservative and radical surgery, sentinel lymph node mapping, and individualized adjuvant therapies. Advances in functional and quantitative imaging, such as DWI, have improved precision in disease grading and treatment tailoring. Core learning points include the necessity of standardized management algorithms, the importance of multiparametric assessments for optimal risk stratification, and the evolving potential of imaging biomarkers to personalize endometrial cancer management and improve patient outcomes.