Ovarian cancer: staging with CT and MR imaging.

Forstner, Rosemarie; Hricak, H.; Occhipinti, K; Powell, C. Bethan; Frankel, Steven A.; Stern, Jeffrey L.

doi:10.1148/radiology.197.3.7480729

Cited by 191 publications

(124 citation statements)

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“…It is also accurate in demonstration of direct involvement of other pelvic structures by the ovarian tumour. The peritoneal and lymph nodal spread detection by MRI is comparable to the CT. 28 Long imaging time required for MRI evaluation of entire abdomen and pelvis makes it less suitable. Lack of universal availability, high cost of examination makes this modality impractical for routine study in ovarian cancer.…”

Section: Discussionmentioning

confidence: 99%

Comparative study of pre-operative CT scan and per-operative findings in carcinoma ovary

Suchitra¹,

P.²,

Kalla³

et al. 2015

Int J Reprod Contracept Obstet Gynecol

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Section: Discussionmentioning

confidence: 99%

Comparative study of pre-operative CT scan and per-operative findings in carcinoma ovary

Suchitra¹,

P.²,

Kalla³

et al. 2015

Int J Reprod Contracept Obstet Gynecol

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“…However, in most UK centres, a residual disease of less than 2 cm remains an acceptable goal. Currently the mainstay of preoperative assessment of such patients with regards to resectability and likelihood of achieving OCR are based on clinical examinations, tumour marker levels and CT findings [8][9][10][11][13][14][15][16]. It is also common practice in UK to administer neo-adjuvant chemotherapy prior to Table 1 Comparison of outcome of mini-laparotomy and laparotomy OCR achieved after full laparotomy OCR not achieved after full laparotomy Total OCR predicted possible on mini-laparotomy 24 (true positive) 3 (false positive) 27 OCR predicted not possible on mini-laparotomy 0 (false negative) 8 (true negative) 8…”

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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“…Some studies have found MRI to be more accurate in this regard, especially for lymph node metastases and tumor resectability. 77,78 Contrast-enhanced MRI have been found to have a 92% sensitivity in detecting small peritoneal disease such as those that can be found in the omentum, in the mesentery of the small and large bowel, on the anterior abdominal peritoneal surface, under the diaphragm, and in the paracolic gutters. 77 Prolonged survival after ovarian cancer diagnosis and the success of chemotherapy depends on optimal debulking at the time of the initial surgery, yet less than 50% of ovarian cancer patients acquire a gynecologic oncologist to be involved in their care.…”

Section: Gynecologic Malignanciesmentioning

confidence: 99%

Imaging Modalities in Gynecology

Busse¹

2010

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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REVIEW ARTICLE DSJUOG ULTRASOUNDTransabdominal gynecologic ultrasound combined with transvaginal scanning is a technique that was initially introduced in the early 1980's and quickly became a "musthave" procedure for gynecologists and emergency room physicians for assistance in diagnosing many gynecologic conditions. Rapid advances in the quality of the equipment, techniques used to obtain best images, and research designed to help physicians interpret their findings have contributed to ultrasound's quick rise in use and popularity. It is ubiquitous that ultrasound is the imaging modality of choice for gynecologic conditions.The advantages of ultrasound are numerous. It is fast, easy to obtain, has a high patient tolerance and is relatively inexpensive when compared to CT and MRI. Many physicians' offices have ultrasound machines that are more than sufficient to make common diagnoses thereby alleviating patient anxiety and physician concerns if an abnormality is found during a physical exam. Appropriate referrals and treatments can be initiated in a timely manner at minimum expense. The ability to use the transvaginal ultrasound as an extension of a pelvic exam is extremely useful, particularly when the source of pain is uncertain during bimanual exam or if a mass is found of uterine or ovarian origin. An obvious advantage, especially when compared to CT, is that no radiation exposure occurs. As will be discussed in more detail, pelvic ultrasound has been shown, in numerous studies, to have a high negative predictive value and offers excellent resolution of the uterus and adnexal structures, especially when compared to CT and MRI.There are disadvantages; however, that should be addressed. Even with routine use of transabdominal scanning which utilizes the acoustic window of a full bladder, the field of view is very limited, especially, compared to CT and MRI. Transvaginal sonography limits the field; however, it is effective in obtaining excellent resolution of the uterus, endometrium and adnexal structures. Ultrasound visualizes the bowel poorly and it is well-known that bowel gas corrupts the ultrasound signal allowing for potential "missed" masses not visible under the bowel. An additional drawback is that poor contrast occurs between dissimilar tissues (i.e. blood and fat) making it difficult to characterize certain ovarian masses accurately.Ultrasound characterizes gynecologic pathology extremely well. Fibroids, endometriomas, dermoids, masses that are suspicious for malignancy, uterine anomalies, IUD complications, ectopic pregnancies, and endometrial pathology (with the help of transvaginal saline infusion sonography) are diagnoses that are detected with high accuracy. The following will give illustrations of the clinical utility of diagnostic gynecologic ultrasound for specific clinical conditions. AbstractAlthough ultrasound is the primary imaging modality for most gynecologic diagnoses and conditions, knowledge of other diagnostic imaging procedures is important to gynecologists, emergency room physici...

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Ovarian cancer: staging with CT and MR imaging.

Abstract: While the staging accuracy of both CT and MR imaging is only moderate, prediction of tumor resectability is excellent.

Cited by 191 publications

References 0 publications

Comparative study of pre-operative CT scan and per-operative findings in carcinoma ovary

Comparative study of pre-operative CT scan and per-operative findings in carcinoma ovary

Mini-laparotomy in advanced ovarian cancer

Imaging Modalities in Gynecology

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