ESGO/ISUOG/IOTA/ESGE Consensus Statement on pre-operative diagnosis of ovarian tumors

Abstract

The European Society of Gynaecological Oncology (ESGO), the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG), the International Ovarian Tumour Analysis (IOTA) group, and the European Society for Gynaecological Endoscopy (ESGE) jointly developed clinically relevant and evidence-based statements on the pre-operative diagnosis of ovarian tumors, including imaging techniques, biomarkers, and prediction models. ESGO/ISUOG/IOTA/ESGE nominated a multidisciplinary international group, including expert practising clinicians and researchers who have demonstrated leadership and expertise in the pre-operative diagnosis of ovarian tumors and management of patients with ovarian cancer (19 experts across Europe). A patient representative was also included in the group. To ensure that the statements were evidence-based, the current literature was reviewed and critically appraised. Preliminary statements were drafted based on the review of the relevant literature. During a conference call, the whole group discussed each preliminary statement and a first round of voting was carried out. Statements were removed when a consensus among group members was not obtained. The voters had the opportunity to provide comments/suggestions with their votes. The statements were then revised accordingly. Another round of voting was carried out according to the same rules to allow the whole group to evaluate the revised version of the statements. The group achieved consensus on 18 statements. This Consensus Statement presents these ESGO/ISUOG/IOTA/ESGE statements on the pre-operative diagnosis of ovarian tumors and the assessment of carcinomatosis, together with a summary of the evidence supporting each statement.

Ovarian Adnexal Reporting Data System (O-RADS) for Classifying Adnexal Masses: A Systematic Review and Meta-Analysis

“…In addition, a recent consensus paper developed by several societies such as the European Society of Gynecologic Oncology (ESGO), the European Society of Gynecologic Endoscopy (ESGE), the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG), and the IOTA group stated that, in spite of the O-RADS classification system not having been validated, it should be used to classify adnexal masses, and the consensus paper provided management guidelines accordingly [39]. Our results now support this recommendation.…”

Low-grade serous ovarian cancer in pregnancy

“…A 33-year-old primigravida was referred to our gynecological oncology unit for evaluation and management of an adnexal mass during pregnancy. At a gestational age of 6 weeks, sonography revealed a multilocular solid left adnexal mass of 90×67×81 mm with a solid component of 49×50×31 mm with moderate vascularization, according to the International Ovarian Tumor Analysis (IOTA) classification1 (Figure 1). Her right ovary was replaced by an irregular solid mass of 74×40×61 mm with four vascularized papillary projections with a maximum height of 24 mm protruding into an internal small cyst.…”

“…In non-pregnant patients, adnexal masses can be adequately diagnosed as benign, borderline or malignant using the preoperative classification system developed by the IOTA group. 1 Pregnancy may, however, pose an additional challenge, as increased estrogen and progesterone levels can alter the sonographic appearance of the ovarian mass. As such, benign decidualized endometriomas might be difficult to differentiate from borderline and/or invasive ovarian masses, as they all may present with papillary projections.…”

“…Its application is mainly of value in cases where ultrasound alone is insufficient to draw a firm conclusion and to stage the disease. 1 Diffusion-weighted MRI is the modality of choice, as administration of gadolinium as used in conventional MRI is known to cross the placenta. Following excretion by the fetal kidney it continues to circulate in the amniotic fluid resulting in high levels of free gadolinium ions, which may have a detrimental effect on the fetus.…”

Quality Requirements for gynecological ultrasound examinations of DEGUM level II – Recommendations of the Sections/Working Groups Gynecology and Obstetrics of DEGUM, ÖGUM and SGUM

“…The potential of MRI, CT, and PET as second-line diagnostics is undisputed, but unfortunately, gynecological issues are currently still being addressed in an unfocused manner by cost-intensive, partly radiation-intensive, and non-specialized techniques. This lack of confidence in gynecologic diagnostics is not evidence-or guideline-based [6]. Other radiological methods are not superior with respect to most issues; radiological cross-sectional imaging techniques can provide relevant information in only a few selected specific issues [7][8][9][10][11][12][13][14][15].…”