Imaging Strategy for Early Ovarian Cancer
Aya Shawky Shahat Emam Mentawy;
Abstract
The etiology of ovarian cancer is still poorly understood; however, some risk factors are described, and family history is considered the strongest risk factor. Epithelial tumors represent approximately 90% of primary ovarian cancers, while the germ cell tumor is the most frequent ovarian malignancies in the young females.
Ovarian cancer is currently the most common leading cause of death among the gynecologic malignancies. Its prevalence in the population, and the fact that diagnosis at an earlier stage leads to markedly improved survival, makes it an ideal candidate for a screening program.
Trials have incorporated multimodal screening protocols which utilize transvaginal ultrasound and measurement of serum CA125 levels. Either to be use concurrently, or one of them as first line, and the other as second line. Serum CA125 as the first line and transvaginal ultrasound as the secondary line achieved a high specificity andpositive predictive value and can positively impact the survival.
Currently, screening for ovarian cancer is not recommended for the general population. Until there is a valid screening test, the symptom index may serve an important role in detecting cancers; and after a test is identified, the index may be useful as a tool in combination with other methods to contribute to early detection. A symptom index was considered positive if any of these 6 symptoms pelvic / abdominal pain, increased abdominal size / bloating, and difficulty eating / feeling full occurred >12 times per month but were present for <1 year.
Trans-vaginal ultrasound is a primary modality for adnexal mass detection and characterization. The current combined technique, which includes assessment of morphologic features and Doppler characteristics, gives the most accurate prediction of malignancy. Many scoring systems are used to standardize diagnosis of ovarian cancer. The scoring system that did best is the risk of malignant index (RMI).RMI calculated using the product of the serum CA125 level, the ultrasound scan result and the menopausal status.
Although contrast enhanced US may be a promising modality in detect ovarian cancer, at present, US morphologic assessment still is the most important and common modality in detecting ovarian cancer.Central color Doppler flow within solid components of an ovarian mass has been shown to be an accurate predictor of malignancy. Pulsed Doppler ultrasonography is not an independent
Ovarian cancer is currently the most common leading cause of death among the gynecologic malignancies. Its prevalence in the population, and the fact that diagnosis at an earlier stage leads to markedly improved survival, makes it an ideal candidate for a screening program.
Trials have incorporated multimodal screening protocols which utilize transvaginal ultrasound and measurement of serum CA125 levels. Either to be use concurrently, or one of them as first line, and the other as second line. Serum CA125 as the first line and transvaginal ultrasound as the secondary line achieved a high specificity andpositive predictive value and can positively impact the survival.
Currently, screening for ovarian cancer is not recommended for the general population. Until there is a valid screening test, the symptom index may serve an important role in detecting cancers; and after a test is identified, the index may be useful as a tool in combination with other methods to contribute to early detection. A symptom index was considered positive if any of these 6 symptoms pelvic / abdominal pain, increased abdominal size / bloating, and difficulty eating / feeling full occurred >12 times per month but were present for <1 year.
Trans-vaginal ultrasound is a primary modality for adnexal mass detection and characterization. The current combined technique, which includes assessment of morphologic features and Doppler characteristics, gives the most accurate prediction of malignancy. Many scoring systems are used to standardize diagnosis of ovarian cancer. The scoring system that did best is the risk of malignant index (RMI).RMI calculated using the product of the serum CA125 level, the ultrasound scan result and the menopausal status.
Although contrast enhanced US may be a promising modality in detect ovarian cancer, at present, US morphologic assessment still is the most important and common modality in detecting ovarian cancer.Central color Doppler flow within solid components of an ovarian mass has been shown to be an accurate predictor of malignancy. Pulsed Doppler ultrasonography is not an independent
Other data
| Title | Imaging Strategy for Early Ovarian Cancer | Other Titles | استراتجية التصوير المبكر لسرطان المبيض | Authors | Aya Shawky Shahat Emam Mentawy | Issue Date | 2015 |
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