Ultrasound in preoperative assessment of pelvic and abdominal spread in patients with ovarian cancer: a prospective study

Fischerová, D.; Zikán, Michal; Semeradova, I; Sláma, Jiří; Kocián, Roman; Dundr, Pavel; Němejcová, Kristýna; Burgetová, Andrea; Dušek, Ladislav; Cibula, David

doi:10.1002/uog.15942

Cited by 37 publications

(37 citation statements)

References 28 publications

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“…However, its diagnostic performance for detecting disease in other areas, such as root of mesentery or pelvic/para-aortic lymph nodes, is limited in terms of sensitivity but high in terms of specificity. These findings are in agreement with data reported by Testa et al14 and Fischerova et al15 (see online supplementary table S1). For CT we also found similar results to those reported in previous studies23–25 (see online supplementary table S2).…”

Section: Discussionsupporting

confidence: 93%

“…Regarding the accuracy of ultrasound for radiological staging, our results are in agreement with those reported by Fischerova et al15 who reported a 75% accuracy (71% in our study). Regarding the accuracy of CT, Moyle et al reported that CT is 70–90% accurate to predict surgical staging 7.…”

Section: Discussionsupporting

confidence: 93%

“…There is still a need to ascertain whether other examiners could replicate these results. Certainly, our results are similar to those reported by Testa et al14 and Fischerova et al15 and it could be inferred that ultrasound might be an adequate technique for assessing tumor spread in ovarian cancer when performed by expert examiners. However, an issue to be assessed in the future is to estimate the learning curve of sonographers/sonologists for this type of ultrasound examination.…”

Section: Discussionsupporting

confidence: 92%

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Pre-operative assessment of intra-abdominal disease spread in epithelial ovarian cancer: a comparative study between ultrasound and computed tomography

Alcázar¹,

Caparrós²,

Sarasa³

et al. 2019

Int J Gynecol Cancer

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ObjectiveTo compare the diagnostic performance of ultrasound and computed tomography (CT) for detecting pelvic and abdominal tumor spread in women with epithelial ovarian cancer.MethodsAn observational cohort study of 93 patients (mean age 57.6 years) with an ultrasound diagnosis of adnexal mass suspected of malignancy and confirmed histologically as epithelial ovarian cancer was undertaken. In all cases, transvaginal and transabdominal ultrasound as well as CT scans were performed to assess the extent of the disease within the pelvis and abdomen prior to surgery. The exploration was systematic, analyzing 12 anatomical areas. All patients underwent surgical staging and/or cytoreductive surgery with an initial laparoscopy for assessing resectability. The surgical and pathological findings were considered as the 'reference standard'. Sensitivity and specificity of ultrasound and CT scanning were calculated for the different anatomical areas and compared using the McNemar test. Agreement between ultrasound and CT staging and the surgical stage was estimated using the weighted kappa index.ResultsThe tumorous stage was International Federation of Gynecology and Obstetrics (FIGO) stage I in 26 cases, stage II in 11 cases, stage III in 47 cases, and stage IV in nine cases. Excluding stages I and IIA cases (n=30), R0 (no macroscopic residual disease) was achieved in 36 women (62.2%), R1 (macroscopic residual disease <1 cm) was achieved in 13 women (25.0%), and R2 (macroscopic residual disease >1 cm) debulking surgery occurred in three women (5.8%). Eleven patients (11.8%) were considered not suitable for optimal debulking surgery during laparoscopic assessment. Overall sensitivity of ultrasound and CT for detecting disease was 70.3% and 60.1%, respectively, and specificity was 97.8% and 93.7%, respectively. The agreement between radiological stage and surgical stage for ultrasound (kappa index 0.69) and CT (kappa index 0.70) was good for both techniques. Overall accuracy to determine tumor stage was 71% for ultrasound and 75% for CT.ConclusionDetailed ultrasound examination renders a similar diagnostic performance to CT for assessing pelvic/abdominal tumor spread in women with epithelial ovarian cancer.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 92%

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Pre-operative assessment of intra-abdominal disease spread in epithelial ovarian cancer: a comparative study between ultrasound and computed tomography

Alcázar¹,

Caparrós²,

Sarasa³

et al. 2019

Int J Gynecol Cancer

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“…Ultrasonography performed by an expert examiner might be a useful strategy for staging and treatment planning [9][10][11]. Recently, it was shown that a detailed transabdominal and transvaginal ultrasound examination, performed by an expert examiner, could render a similar diagnostic performance to CT for assessing pelvic/abdominal tumor spread disease in women with EOC [11].…”

Section: Introductionmentioning

confidence: 99%

Lung and Intercostal Upper Abdomen Ultrasonography for Staging Patients with Ovarian Cancer: A Method Description and Feasibility Study

et al. 2020

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A detailed transabdominal and transvaginal ultrasound examination, performed by an expert examiner, could render a similar diagnostic performance to computed tomography for assessing pelvic/abdominal tumor spread disease in women with epithelial ovarian cancer (EOC). This study aimed to describe and assess the feasibility of lung and intercostal upper abdomen ultrasonography as pretreatment imaging of EOC metastases of supradiaphragmatic and subdiaphragmatic areas. A preoperative ultrasound examination of consecutive patients suspected of having EOC was prospectively performed using transvaginal, transabdominal, and intercostal lung and upper abdomen ultrasonography. A surgical-pathological examination was the reference standard to ultrasonography. Among 77 patients with histologically proven EOC, supradiaphragmatic disease was detected in 13 cases: pleural effusions on the right (n = 12) and left (n = 8) sides, nodular lesions on diaphragmatic pleura (n = 9), focal lesion in lung parenchyma (n = 1), and enlarged cardiophrenic lymph nodes (n = 1). Performance (described with area under the curve) of combined transabdominal and intercostal upper abdomen ultrasonography for subdiaphragmatic areas (n = 77) included the right and left diaphragm peritoneum (0.754 and 0.575 respectively), spleen hilum (0.924), hepatic hilum (0.701), and liver and spleen parenchyma (0.993 and 1.0 respectively). It was not possible to evaluate the performance of lung ultrasonography for supradiaphragmatic disease because only some patients had this region surgically explored. Preoperative lung and intercostal upper abdomen ultrasonography performed in patients with EOC can add valuable information for supradiaphragmatic and subdiaphragmatic regions. A reliable reference standard to test method performance is an area of future research. A multidisciplinary approach to ovarian cancer utilizing lung ultrasonography may assist in clinical decision-making.

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“…The overall accuracy was >91% in assessing pelvic involvement, parenchymal liver metastasis, ascites, peritoneal carcinomatosis, and omental infiltration. Fisherova and colleagues3 published the largest prospective imaging study evaluating a total of 394 ovarian cancer patients. That study evaluated ultrasound accuracy in assessing pelvic and intra-abdominal spread of disease and described predictive power for detection of pelvic carcinomatosis (area under the curve (AUC) 0.892; sensitivity 81.4%; specificity 97%) and rectosigmoid wall infiltration (AUC 0.898; sensitivity 83.1%; specificity 96.6%).…”

mentioning

confidence: 99%

Pre-operative evaluation in advanced ovarian cancer: is ultrasound ready to replace computed tomography?

Verri¹

2019

Int J Gynecol Cancer

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Ultrasound in preoperative assessment of pelvic and abdominal spread in patients with ovarian cancer: a prospective study

Cited by 37 publications

References 28 publications

Pre-operative assessment of intra-abdominal disease spread in epithelial ovarian cancer: a comparative study between ultrasound and computed tomography

Pre-operative assessment of intra-abdominal disease spread in epithelial ovarian cancer: a comparative study between ultrasound and computed tomography

Lung and Intercostal Upper Abdomen Ultrasonography for Staging Patients with Ovarian Cancer: A Method Description and Feasibility Study

Pre-operative evaluation in advanced ovarian cancer: is ultrasound ready to replace computed tomography?

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