Learning objectives
To discuss the role of ultrasound,
CT,
MRI and PET CT in the presurgical assessment of ovarian cancer.
To identify critical imaging findings in ovarian cancer staging.
To discuss imaging pitfalls.
Background
Ovarian cancer is the fifth most common cause of cancer death in women (1).
Epithelial ovarian malignancies are the commonest (approximately 85%),
with high grade serous carcinoma as the most frequent subtype.
Overall 5-year survival rate for ovarian cancer is estimated to be 46% but it’s quite variable for the different stages estimated at about 90% for stage I,
more 40% for stage II,
almost 20% for stage III and around 5% for stage IV (2).
Although surgical staging based on the FIGO classification is...
Findings and procedure details
Imaging techniques:
The primary modality for evaluation of adnexal masses is ultrasound.
According to IOTA simple rules,
if at least one of the M features is present (an irregular solid tumor,
presence of ascites,
papillary projections,
irregular multilocular solid tumors larger than 10 cm and strong blood flow) and no B feature is present,
this suggests a high likelihood for malignancy (4,
5).
If at least one B featureis present(a unilocular cyst with solid component less than 7 mm,
acoustic shadowing,
smooth multilocular tumor less...
Conclusion
Accurate radiological staging of ovarian cancer is very important in guiding key patient management decisions,
and predicting overall survival.
Radiologists should be familiar with radiological staging with regards to the optimal imaging modality,
technique and interpretation.
Although currently not supported by robust evidence,
functional MRI is developing and may be critical in the future of ovarian cancer staging.
On the basis of known patterns of disease spread,
review area should be given sufficient attention during imaging interpretation.
References
1.
American cancer society,
“Cancer facts & figures 2017.”
2.
“http://www.cancerresearchuk.org/about-cancer/ovarian-cancer/survival,” consulted in September 2017.
3.
SEER Cancer Stat Facts: Ovarian Cancer.
National Cancer Institute.,” Bethesda,
MD,
http://seer.cancer.gov/statfacts/html/ovary.htmle.
Accessed in October 2017.
4.
A.
Peces Rama,
M.
C.
Llanos Llanos,
M.
L.
Sanchez Ferrer,
J.
L.
Alcazar Zambrano,
A.
Martinez
Mendoza,
and A.
Nieto Diaz,
“Simple descriptors and simple rules of the International OvarianTumor Analysis (IOTA) Group: a prospective study of combined use for the description of adnexal masses.,” Eur.
J.
Obstet.
Gynecol.
Reprod.
Biol.,...