Diagnosis and Staging of Ovarian Cancer: Comparative Values of Doppler and Conventional US, CT, and MR Imaging Correlated with Surgery and Histopathologic Analysis—Report of the Radiology Diagnostic Oncology Group

Kurtz, Alfred B.; Tsimikas, John V.; Tempany, Clare M.; Hamper, Ulrike M.; Arger, Peter H.; Bree, Robert L.; Wechsler, Richard J.; Francis, Isaac R.; Kuhlman, Janet E.; Siegelman, Evan S.; Mitchell, Donald G.; Silverman, Stuart G.; Brown, Douglas L.; Sheth, Sheila; Coleman, Beverly G.; Ellis, James H.; Kurman, Robert J.; Caudry, Daryl J.; McNeil, Barbara J.

doi:10.1148/radiology.212.1.r99jl3619

Cited by 248 publications

(123 citation statements)

References 43 publications

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“…Similar studies showed that chance of malignancy in such cysts are very low about < 1% [17][18][19][20][21] .…”

Section: Discussionmentioning

confidence: 85%

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Management of Postmenopausal Women with Simple Cyst

Nasreen¹

2017

Bangladesh J Obstet Gynaecol

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Introduction:Ovarian cysts in postmenopausal women are now known to be very common and maximum are not malignant. The exact prevalence is unknown given the limited amount of published data and the lack of established screening programs for ovarian cancer. However, studies have estimated the incidence to be anywhere between 5% and 17% 1-4 and 60-70% of unilocular cyst resolved spontaneously [5][6][7][8] . In Bangladesh we do not have exact data for the incidence but postmenopausal women with cysts are diagnosed as routine USG or in a woman who complains of slight discomfort in lower abdomen for any reason. Ovarian cancer remains the leading cause of death due to gynecological malignancy in many countries. Owing to very high mortality and severe morbidities, any postmenopausal woman is scared even with simple cyst. Before the era of USG if pelvic examination revealed palpable ovaries, those ovaries were removed. Now USG is able to detect cysts far before it becomes palpable and most of them are benign. Many women honor the ovaries and not happy to remove it. On the other hand once cysts are found in post menopausal women many women get frightened and request for the removal of cysts. So the gynecologist often faces the real challenge to treat Original Articles

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“…Similar studies showed that chance of malignancy in such cysts are very low about < 1% [17][18][19][20][21] .…”

Section: Discussionmentioning

confidence: 85%

“…One study indicates that MRI may be superior to CT scan and ultrasound scan, in diagnosing ovarian mass but there is no difference in its' ability to distinguish between benign and malignant diseases 15 . Another study found that TVS has greater sensitivity than CT or MRI in this regard 16 .…”

Section: Discussionmentioning

confidence: 99%

Management of Postmenopausal Women with Simple Cyst

Nasreen¹

2017

Bangladesh J Obstet Gynaecol

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“…Current preoperative assessments have limited predictability in selection of patients suitable for OCR. The sensitivity of CT in identifying patients that OCR can be achieved is around 60-70%, with varying reported specificity between 70% and 100% [17,18]. The main drawbacks of CT imaging is the inability to reliably assess the extent of disease in the supra colic compartment, porta hepatis, miliary disease over bowel mesentery and peritoneum, especially in absence of ascites [8][9][10][11]19].…”

Section: Discussionmentioning

confidence: 99%

Mini-laparotomy in advanced ovarian cancer

et al. 2011

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Optimal cytoreduction (OCR) remains the gold standard treatment of ovarian cancer. Current radiological imaging has limited sensitivity and specificity in prediction of achieving OCR prior to surgery. This prospective pilot study included 50 patients with advanced ovarian carcinoma. Prior to the main laparotomy, a mini-laparotomy-just large enough to allow a hand in-was performed. A decision was then made as to whether achieving OCR is "possible", "not possible" or lastly "unsure". Formal laparotomy then followed. At the end of the formal laparotomy, cytoreduction was regarded as either "optimal" or "suboptimal" based on residual disease. Out of 45 cases where results were deemed suitable for analysis, 27 were regarded as "OCR possible", out of which OCR was achieved in 24 cases following full laparotomy. Ten were commented upon as "unsure" and only in three cases OCR was feasible. Eight were classed as "OCR not possible" and in none of these OCR was obtained. The only noted complication associated with minilaparotomy was bleeding in just three cases (6%). The sensitivity, specificity, PPV and NPV of mini-laparotomy were 100%, 73%, 89% and 100%, respectively. However, when "unsure", only in 30% OCR was achieved. We concluded that mini-laparotomy is a safe, simple and effective technique for predicting feasibility of OCR. This simple technique could obviate the need for full laparotomy in patients who may benefit from neo-adjuvant chemotherapy.

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“…Bimanual pelvic examination and serum CA-125 levels have failed to allow consistent detection of ovarian malignancy. Because the sensitivities of these techniques are often below 50%, imaging modalities have become indispensable (Jacobs et al, 1989;Taylor et al, 1994;Kurtz et al, 1999;Ferozabadi et al, 2011). Sonography has been shown to be a sensitive, but relatively nonspecific method, leading to unnecessary surgical resection of many benign lesions (Outwater et al, 1995).…”

Section: Introductionmentioning

confidence: 99%