Imaging of Pelvic Lymph Nodes

Imaging evaluation to determine the status of pelvic lymph nodes has yet to attain benchmark status clinically. On one hand, pelvic lymphatic drainage is complex and varies depending on the types and locations of primary tumors. On the other hand, current imaging techniques still have the potential to improve the detection of micrometastatic lesions and differentiation between hyperplastic and malignant nodes. This article addresses the strengths and weaknesses of imaging techniques as well as specific lymphatic metastatic routes that could increase the diagnostic confidence concerning pelvic lymph nodes.