Advantages and Limitations of Ultrasound as a Screening Test for Ovarian Cancer

Abstract

Ovarian cancer (OC) is the seventh most common malignancy diagnosed among women, the eighth leading cause of cancer mortality globally, and the most common cause of death among all gynecological cancers. Even though recent advances in technology have allowed for more accurate radiological and laboratory diagnostic tests, approximately 60% of OC cases are diagnosed at an advanced stage. Given the high mortality rate of advanced stages of OC, early diagnosis remains the main prognostic factor. Our aim is to focus on the sonographic challenges in ovarian cancer screening and to highlight the importance of sonographic evaluation, the crucial role of the operator΄s experience, possible limitations in visibility, emphasizing the importance and the necessity of quality assurance protocols that health workers have to follow and finally increasing the positive predictive value. We also analyzed how ultrasound can be combined with biomarkers (ex. CA-125) so as to increase the sensitivity of early-stage OC detection or, in addition to the gold standard examination, the CT (Computed tomography) scan in OC follow–up. Improvements in the performance and consistency of ultrasound screening could reduce the need for repeated examinations and, mainly, ensure diagnostic accuracy. Finally, we refer to new very promising techniques such as liquid biopsies. Future attempts in order to improve screening should focus on the identification of features that are unique to OC and that are present in early-stage tumors.

Revolutionizing Women’s Health: A Comprehensive Review of Artificial Intelligence Advancements in Gynecology

“…Additionally, this exam can be performed preoperatively in the evaluation of an ovarian tumor. However, despite a satisfactory sensitivity for diagnosing ovarian cancer, its low PPV limits its implementation and results frequently in unnecessary procedures or concerns [71]. In fact, the distinction between benign and malign ovarian findings is challenging.…”

Modern Approaches and Future Perspectives on Breast and Ovarian Cancer Prevention Strategies in BRCA1 and BRCA2 Mutation Carriers: A Literature Overview

“…[6] The efficacy of ultrasonographic assessment is limited by an early time of detection, visibility constraints and the operator's experience. [11] CA125 is currently regarded as the most dependable biomarker for ovarian cancer, but its sensitivity varies from 50% to 62%, and its specificity ranges from 73% to 77%. [12] In contemporary practice, it is primarily used as a component of multivariate algorithms, such as ROMA, RMI, or OVA1, all aimed at increasing its effectiveness.…”

A Comprehensive Review of Screening Methods for Ovarian Masses: Towards Earlier Detection

“…Research has shown that IOTA's models and guidelines can significantly improve the specificity and sensitivity of ultrasound in distinguishing between benign and malignant masses. By providing a structured approach to the ultrasound-based assessment of ovarian masses, IOTA's contributions offer a valuable resource for clinicians and sonographers, aiding in more accurate and consistent diagnoses [ 55 ]. IOTA researches to refine its models and guidelines and offers training programs to promote their widespread and consistent use in clinical practice.…”