Computed tomography as a predictor of the extent of the disease and surgical outcomes in ovarian cancer

Abstract

Objectives: The aim of the present study is to determine the predictive value of Computed Tomography (CT), alone or in combination with serum CA-125 levels, for preoperative staging, detection of the extent of the disease, and surgical complications in patients with ovarian carcinoma. Material and methods:One hundred and fourteen patients diagnosed with ovarian carcinoma following an exploratory laparotomy with a preoperative CT scan, performed between January 2007 and June 2013, were enrolled in the study. Preoperative CT and intraoperative surgical findings were compared using 14 parameters and predictions of CT for gastrointestinal, genitourinary, and cardiovascular complications. All radiological features and clinical characteristics were analyzed statistically.Results: CT and surgical findings correlated (sensitivity/ specificity) as follows: uterine and tubal spread (66%/89%), cervical involvement (100%/80%), peritoneal nodulesincreased density-carcinomatosis (57%/93%), omental involvement (68%/95%), retroperitoneal involvement (25%/84%), ascites (85%/87%), perirectal and perivesical fat plan obliteration (43%/94%), liver metastasis (50%/91%), small and large bowel involvement (47%/95%), adnexal mass (94%/70%), and other metastases (47%/86%). Also, CT findings were found to be statistically insignificant for prediction of mesenteric involvement, bladder metastasis, and diaphragmatic involvement. The overall CT sensitivity and specificity at detecting intraoperative findings was 91% and 71%, respectively. We found a statistically significant correlation between intestinal involvement on CT and the necessity of additional surgical procedures. Conclusions:CT is a widely used imaging method in the preoperative evaluation of ovarian cancer. However, its predictive value, sensitivity and specificity differ, depending on the anatomical region.

Development of Peritoneal Carcinomatosis in Epithelial Ovarian Cancer: A Review

“…Metastases of EOC may incidentally grow through the viscera of the bowel or the bladder. 79 The visceral and parietal peritoneal surfaces have a similar structural composition throughout the abdomen. The incidental invasive growth in specific areas, therefore, suggests that the peritoneal microenvironment, or structures that support the peritoneum, play a role in the development of deep invasive growth.…”

Imaging of Peritoneal Metastases in Ovarian Cancer Using MDCT, MRI, and FDG PET/CT: A Systematic Review and Meta-Analysis

“…In total, 23 datasets evaluated the presence of PMs in OC with MDCT [26,27,30,52,[56][57][58][59][63][64][65][66][67][68][69][70][71][72][73][74][75][76]78] (Table 4); 2, 3, and 8 studies were performed on a 4-row [52,58], 16-row [56,57,74], and 64-row [27,30,59,63,67,70,72,75] MDCT scanner, respectively, 4 studies used both a 16-row and a 64-row CT [64,66,73,76], and 1 report used a 4-row, a 16-row, and a 64-row [65] CT machine (Table 5). Overall, 20 studies [27,30,52,[56][57][58]...…”

“…Overall, 20 studies [27,30,52,[56][57][58][59][63][64][65][66][67][68][69][70][71][72][73][74]76,78] reported the intravenous administration of iodinated contrast medium; 10 of them used the portal phase [27,56-59, 66-68,73,78], 4 used both the arterial and the portal phase [52,65,74,76], 1 used the arterial phase [72], and 1 study used both the portal and the delayed phase [69]. The use of luminal contrast was reported in 15 studies [30,52,[64][65][66][67][68][69][70][71][72][73][74]76,78]; 8 studies reported the oral administration of H 2 O and diluted contrast medium, including iodinated contrast material in 4 reports [30,66,74,…”

“…Six studies were performed on a 16-row [42,56,57,64,67,68] scanner, four on a 64-row [30,63,70,77] system, and three studies, each one used a 4-row [54], an 8-row [55], and a spiral [66] CT machine (Table 7). The following reference tests were used: surgical and histopathologic results (n = 21) [26,30,42,44,51,53,54,57,60,[62][63][64][65]67,71,72,[74][75][76][77][78], surgical findings (n = 3) [52,58,68], surgical and histopathologic results or follow-up (n = 8) [27,55,56,59,61,66,70,73], and follow-up (n = 1) [69] (Table 4).…”

Diagnostic imaging in gynecology

“…Serous cystic adenocarcinomas may contain microcalcifications. Serous cystic adenomas are usually small and single-celled, whereas mucous cystic adenomas are larger multicellular clusters [13]. Mucinous tumors are attenuated on CT and have heterogeneous signal intensity on T1-weighted and T2-weighted MRI images, which results in the appearance of "stained glass".…”