Early Detection of Ovarian Cancer with Transvaginal Microbubble Sonography: Current and Potential Applications

Abstract

Contrast Enhanced microbubble Transvaginal Sonography (CE-TVS) can distinguish benign and malignant ovarian tumors. Initial results from several medical centers around the world have indicated that there are unique enhancement patterns in ovarian neoplasms. Challenges to the implementation of CE-TVS remain since some aggressive ovarian tumors (type 2) that arise in the tubal epithelium and metastasize without producing a clinically detectable mass may be difficult to detect. This is being addressed through the use of labelled microbubbles which can detect rapidly growing tumor vessels. As shown in an avian model, labelled microbubbles can be used to detect neoplastic vessels associated with tumor neoangiogenesis. This has been achieved in vitro by fabrication of microbubbles that have antibody attached to the lipid coat. In this manner, microscopic tumors that arise in the tubal epithelium might be detected in patients. This short communication describes the potential for contrast enhanced sonography to provide a means for early detection of ovarian cancer.

Role of Combining Colour Doppler With Ultrasonography in T He Evaluation of Adnexal Masses

“…(25) RESEARCH AND FUTURE POSSIBILITIES Development of technology in future and introduction of "3D quantification of blood flow" called "the 3D colour histogram," may improve differentiation between benign and malignant ovarian tumors. (26)(27)(28) Microbubble enhanced transvaginal sonography is also being tried to improve the diagnosis of malignant masses by early detection of tumour microvascularity. Using microbubbles that are small enough to pass through capillaries, the kinetics of the blood flow can be analysed to detect abnormal flow found in areas of neovascularisation.…”

Early Detection of Type II Ovarian Cancer with ¡gj| Labelled Microbubble Transvaginal Sonography

“…Microbubbles are also being used in pediatric patients who receive blunt trauma with imaging of the kidneys, spleen, liver and pancreas. Initial studies have demonstrated significant differences in vascular enhancements of benign versus malignant masses [1][2][3]. Although contrast-enhanced transvaginal sonography cannot distinguish between borderline and malignant masses, both require surgical intervention [3].…”

“…However early detection can potentially improve the survival rate from 50 to 90%. Transvaginal sonography with the use of contrast-enhanced microbubbles has shown promise when used to detect malignant ovarian lesions in several studies [1][2][3]. This brief communication addresses the need and potential benefits of contrast enhanced transvaginal sonography, as well as directions for future research and clinical applications.…”

“…However, early detection can significantly increase the survival rate from 50 to 90%. Earlier diagnosis and cancer confinement to the ovary can lead to much more favorable outcomes for patients [3]. One method to facilitate early detection is through screening, but currently available tools, such as biomarkers and imaging, lack sensitivity and specificity for certain ovarian tumors in early and more treatable stages.…”

“…Thus theoretically, based on growth patterns, annual screening with transvaginal sonography and CA125 alone would be more effective in Asia (predominantly type I cancers) than in the USA and Europe (predominantly type II cancers) [5]. Although there has been successful detection of these lesions in animal studies, early detection of type II ovarian cancer remains a challenge [3,5].…”