Whitney DiFiore

Article Title: Diagnosis and Staging of Ovarian Cancer: Comparative Values of Doppler
and Conventional US, CT, and MR Imaging Correlated with Surgery and Histopathology
Analysis-Report of the Radiology Diagnostic Oncology Group

Ovarian cancer is the second most common gynecological malignancy in the United
States with 25,400 new cases detected yearly, 70% are in advance stages. Determining the
malignancy and evaluating the tumor extent are a few diagnostic challenges when an ovarian
mass is detected. There are four stages of ovarian cancer, stage 1 confined to the ovaries, stage 2
spread into pelvis, stage 3 abdominal spread, and stage 4 has spread even further.
The diagnostic research was completed in order to determine whether the results of the
following methods would provide the best results of diagnosing a malignant Ovarian mass and
staging of its spread. Those methods are Doppler and conventional ultrasonography (US),
computed tomography (CT), or magnetic resonance imaging (MRI).
This study was completed by Brigham and Womens hospital, University of Michigan
Hospitals, Hospital of the University of Pennsylvania, John Hopkins Hospital, and Thomas
Jefferson University Hospital. 280 patients that were women over the age of 18 and were
suspected to have Ovarian cancer on the basis of abnormal results of a pelvic physical exam
and/or preliminary pelvic US study were part of the studied group. Conventional and Doppler
US protocol, premenopausal women received US within 8 days of cycle. CT protocol, patients
injected with 150mL of 60% contrast material. MRI protocol, patients received a pelvic and
abdominal imaging. There were three radiologists, one for each modality from each place that
read the results.

Ovarian masses were surgically removed in all 280 patients. 35 of which were in stage 1,
13 in stage 2, and 70 in stage 3 or 4. The other 162 had benign neoplasms. All three modalities
were used on 103 patients and only two modalities on 170 patients. The use of MRI had a high
diagnostic rate finding the malignancy than the other two. The differences between the three
modalities are not statistically significant.
The intent of this research paper was to compare the abilities of Doppler US, CT and
MRI for diagnosis of malignancy masses. Initially US was used to detect all masses, if
something was detected than MRI and CT should have been used. Over staging of the surgeries
could lead to a wider surgical approach, but makes it so the tumors a not overlooked. Under
staging causes the extension of original plan of surgery and tumors are often missed. The results
turned out that MRI superior to US and CT with the diagnosis of the ovarian cancer.