S3-Guideline on Diagnostics, Therapy and Follow-up of Malignant Ovarian Tumours

Wagner, Uwe; Harter, Philipp; Hilpert, Felix; Mahner, Sven; Reuß, Alexander; Bois, Andreas du; Petru, Edgar; Meier, W.; Ortner, Petra; König, Klaus; Lindel, Katja; Grab, Dieter; Piso, Pompiliu; Ortmann, O.; Runnebaum, Ingo B.; Pfisterer, Jacobus; Lüftner, Diana; Frickhofen, Norbert; Grünwald, Frank; Maier, Bernd Oliver; Diebold, Joachim; Hauptmann, Steffen; Kommoss, Friedrich; Emons, G.; Radeleff, Boris; Gebhardt, M.; Arnold, Norbert; Calaminus, Gabriele; Weisse, Isolde; Weis, Joachim; Sehouli, Jalid; Fink, Daniel; Burges, Alexander; Hasenburg, Annette; Eggert, Christoph H.

doi:10.1055/s-0033-1350713

Cited by 38 publications

(24 citation statements)

References 225 publications

(44 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Histopathologic sampling of all suspected lesions would have been desirable to provide a clean reference standard. However, current guidelines (13,14) and clinical patient management do not require histopathologic sampling of all suggestive lesions in order to initiate appropriate patient management and therapy. Therefore, in accordance with previous publications on PET/MR imaging, we used all applicable histopathologic results and cross-sectional imaging follow-up results as the reference standard (15,16).…”

Section: Discussionmentioning

confidence: 99%

“…In the remaining 9 patients, tumor relapse was not confirmed histopathologically, because current guidelines do not call for surgery or histopathologic confirmation in recurrences of specific cancer types. (13,14). Therefore, when histopathologic confirmation was not available, only patients with an imaging follow-up of at least 6 mo were included.…”

Section: Reference Standardmentioning

confidence: 99%

See 1 more Smart Citation

Diagnostic Value of Diffusion-Weighted Imaging in Simultaneous ¹⁸F-FDG PET/MR Imaging for Whole-Body Staging of Women with Pelvic Malignancies

et al. 2014

View full text Add to dashboard Cite

The aim of this study was to assess the diagnostic benefit of diffusion-weighted imaging (DWI) in an 18 F-FDG PET/MR imaging protocol for whole-body staging of women with primary or recurrent malignancies of the pelvis. Methods: Forty-eight patients with a primary pelvic malignancy or suspected recurrence of a pelvic malignancy were included in our study. All patients underwent a whole-body 18 F-FDG PET/MR imaging examination that included DWI. Two radiologists separately evaluated the PET/MR imaging datasets without DWI followed by a second interpretation with DWI. First, both readers identified all primary tumors, as well as lymph node and distant metastases. In a second session, PET and DWI data were assessed qualitatively. Image interpretation comprised lesion conspicuity defined as visual lesion-to-background contrast (4-point ordinal scale) and diagnostic confidence (3-point ordinal scale) for all tumors. The results from histopathologic examination and cross-sectional imaging follow-up ($6 mo) were used as the reference standard. Statistical analysis was performed to assess the significance of differences between obtained values. Results: Among the 122 suspected lesions seen, 98 (80.3%) were considered malignant. PET/MR imaging without DWI had a sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of 92.9%, 87.5%, 96.8%, 75.0%, and 91.8%, respectively, for the detection of malignant lesions. PET/MR imaging with DWI had slightly higher values (94.9%, 83.3%, 95.9%, 80.0%, and 92.6%, respectively), but the difference was not significant (P . 0.05). In the qualitative assessment of lesion-to-background contrast, PET had significantly (P , 0.05) higher values (3.79 ± 0.58) than DWI (3.63 ± 0.77). Furthermore, significantly (P , 0.05) higher scores were found for diagnostic confidence using PET (2.68 ± 0.64) for the determination of malignant lesions, when compared with DWI (2.53 ± 0.69). Conclusion: DWI in PET/MR imaging has no diagnostic benefit for whole-body staging of women with pelvic malignancies. The omission of DWI for staging or restaging gynecologic cancer may significantly reduce examination times, thus increasing patient comfort without a relevant decrease in diagnostic competence.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Reference Standardmentioning

confidence: 99%

Diagnostic Value of Diffusion-Weighted Imaging in Simultaneous ¹⁸F-FDG PET/MR Imaging for Whole-Body Staging of Women with Pelvic Malignancies

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Therapie der Wahl endometrioseassoziierter Malignome -sowohl EAOC als auch der extragonadalen EAM -besteht in der Resektion im Gesunden; die EAOC werden dabei dem leitliniengerechten operativen Staging unterzogen [42,46]. Die komplette chirurgische Entfernung ist fast immer gut durchführ-bar, da extrapelvine Manifestationenim Gegensatz zu den high-grade serösen Ovarialkarzinomen, die ja in der Mehrzahl im Stadium FIGO III diagnostiziert werden -bei diesen Tumoren selten sind.…”

Section: Bisherige Klinische Bedeutungunclassified

Malignome auf dem Boden einer Endometriose

Ulrich

Drienko

Reichert

et al. 2016

Gynäkologische Endokrinologie

View full text Add to dashboard Cite

Zwischen 5 und 15 % aller Frauen in der Prämenopause sind von Endometriose betroffen [33] -und für Frauen mit Sterilität stellt diese Erkrankung ein besonderes Problem dar [12]. Operative Entfernung, endokrine Behandlung und bei unerfülltem Kinderwunsch die assistierte Reproduktion sind die Säulen der Therapie [41]. Pathologisch-histologisch ist die Endometriose prinzipiell eine benigne Erkrankung. Malignes Wachstum und Endometriose weisen jedoch einige gemeinsame Charakteristika auf, und auf dem Boden einer Endometriose können sich Malignome entwickeln [37]. Mit diesem Phänomen beschäftigen sich die Autoren in der folgenden Übersicht.

show abstract

“…On the other hand, comprehensive staging surgery including PEL-LNX and PAO-LNX is recommended by several recent guidelines and often upstages women presumed to have early-stage disease. 10,11 It was reported that the mean incidences of lymph node metastases in clinical stage I-II EOC and CCC were 14.2% and 14.4%, respectively. 12 To evaluate the impact of surgical staging in stage I CCC, we retrospectively reviewed outcomes in 165 stage I CCC patients who underwent optimal or nonoptimal surgical staging.…”

mentioning

confidence: 99%

Impact of Surgical Staging in Stage I Clear Cell Adenocarcinoma of the Ovary

Suzuki

Takakura

Saito

et al. 2014

Int J Gynecol Cancer

View full text Add to dashboard Cite

show abstract

S3-Guideline on Diagnostics, Therapy and Follow-up of Malignant Ovarian Tumours

Abstract: German Guideline Programme in Oncology (OL) of the Association of the Scientific Medical Societies in Germany (AWMF), the German Cancer Society (DKG) and German Cancer Aid (DKH). 1.2 Leading professional society Germany Society for Gynaecology and Obstetrics (DGGG).

Cited by 38 publications

References 225 publications

Diagnostic Value of Diffusion-Weighted Imaging in Simultaneous ¹⁸F-FDG PET/MR Imaging for Whole-Body Staging of Women with Pelvic Malignancies

Diagnostic Value of Diffusion-Weighted Imaging in Simultaneous ¹⁸F-FDG PET/MR Imaging for Whole-Body Staging of Women with Pelvic Malignancies

Malignome auf dem Boden einer Endometriose

Impact of Surgical Staging in Stage I Clear Cell Adenocarcinoma of the Ovary

Contact Info

Product

Resources

About

S3-Guideline on Diagnostics, Therapy and Follow-up of Malignant Ovarian Tumours

Abstract: German Guideline Programme in Oncology (OL) of the Association of the Scientific Medical Societies in Germany (AWMF), the German Cancer Society (DKG) and German Cancer Aid (DKH). 1.2 Leading professional society Germany Society for Gynaecology and Obstetrics (DGGG).

Cited by 38 publications

References 225 publications

Diagnostic Value of Diffusion-Weighted Imaging in Simultaneous 18F-FDG PET/MR Imaging for Whole-Body Staging of Women with Pelvic Malignancies

Diagnostic Value of Diffusion-Weighted Imaging in Simultaneous 18F-FDG PET/MR Imaging for Whole-Body Staging of Women with Pelvic Malignancies

Malignome auf dem Boden einer Endometriose

Impact of Surgical Staging in Stage I Clear Cell Adenocarcinoma of the Ovary

Contact Info

Product

Resources

About

Diagnostic Value of Diffusion-Weighted Imaging in Simultaneous ¹⁸F-FDG PET/MR Imaging for Whole-Body Staging of Women with Pelvic Malignancies

Diagnostic Value of Diffusion-Weighted Imaging in Simultaneous ¹⁸F-FDG PET/MR Imaging for Whole-Body Staging of Women with Pelvic Malignancies