Imaging If early cancer is suspected, ultrasonography is done first; the following findings suggest cancer: A solid component Surface excrescences Size > 6 cm Irregular shape Low vascular resistance detected by transvaginal Doppler flow studies If advanced cancer is suspected (eg, based on ascites, abdominal distention, or nodularity or fixation detected during physical examination), CT or MRI is usually done before surgery to determine extent of the cancer.