Errors in Ultrasound Diagnosis of Gynecologic Cancer: Analysis of Causes

Abstract

alignant tumors of reproductive system are the most incident cancers in women (more than 35% in total). Because of its validity, non-invasiveness, safety, accessibility, repeatability, and relative simplicity nowadays ultrasonography is one of the leading diagnostic methods in gynecologic oncology. However, despite high resolving power of this method, the frequency of errors in topical diagnosis of pelvic lesions, their characterization, and degree of tumor spread assessment remains around 10-30%.Purpose. To identify and analyze causes of errors in ultrasound diagnosis in gynecologic oncology.Materials and methods. We analyzed pre-operative ultrasound protocols from 1167 women with cervical cancer, endometrial cancer, and ovarian cancer who were getting treatment at our facility. Ultrasound results were compared with intraoperative data and pathology results.Results. We analyzed causes of 68 subjective and objective errors in assessing local and distant spread of the tumor. Objective errors were predominantly associated with the limit of the scanner resolving power and the subjective ones were related to the ultrasound exam technique and incorrect interpretation of the results by a specialist. Conclusion.Incorrect interpretation of ultrasound data associated with subjective causes results in incomplete, partially wrong or wrong diagnosis. Frequency of objective errors can be decreased with proper equipping of ultrasound departments while frequency of subjective errors can be decreased with proper ultrasound exam technique.