Contrast-Enhanced Transvaginal Sonography of Ovarian Masses: Potential Role in Early Diagnosis of Ovarian Cancer

ObjectivesTo assess the value of conventional, Doppler and contrast-enhanced ultrasonography (CEUS) (conventional ultrasonography (US), Doppler US and CEUS) for diagnosing ovarian cancer.DesignSystematic review and meta-analysis.Data sourcesPubMed, Embase and the Cochrane Library were conducted for studies published until October 2021.Eligibility criteriaStudies assessed the diagnostic value of conventional US, Doppler US or CEUS for detecting ovarian cancer, with no restrictions placed on published language and status.Data extraction and synthesisThe study selection and data extraction were performed by two independent authors. The sensitivity, specificity, positive and negative likelihood ratio (PLR and NLR), diagnostic OR (DOR) and area under the receiver operating characteristic curve (AUC) were pooled using the bivariate generalised linear mixed model and random effects model.ResultsThe meta-analysis included 72 studies and involved 9296 women who presented with ovarian masses. The pooled sensitivity, specificity, PLR, NLR, DOR and AUC for conventional US were 0.91 (95% CI: 0.87 to 0.94) and 0.87 (95% CI: 0.82 to 0.91), 6.87 (95% CI: 4.98 to 9.49) and 0.10 (95% CI: 0.07 to 0.15), 57.52 (95% CI: 36.64 to 90.28) and 0.95 (95% CI: 0.93 to 0.97), respectively. The sensitivity, specificity, PLR, NLR, DOR and AUC for Doppler US were 0.93 (95% CI: 0.91 to 0.95) and 0.85 (95% CI: 0.80 to 0.89), 6.10 (95% CI: 4.59 to 8.11) and 0.08 (95% CI: 0.06 to 0.11), 61.76 (95% CI: 39.99 to 95.37) and 0.96 (95% CI: 0.94 to 0.97), respectively. The pooled sensitivity, specificity, PLR, NLR, DOR and AUC for CEUS were 0.97 (95% CI: 0.92 to 0.99) and 0.92 (95% CI: 0.85 to 0.95), 11.47 (95% CI: 6.52 to 20.17) and 0.03 (95% CI: 0.01 to 0.09), 152.11 (95% CI: 77.77 to 297.51) and 0.99 (95% CI: 0.97 to 0.99), respectively. Moreover, the AUC values for conventional US (p=0.002) and Doppler US (p=0.005) were inferior to those of CEUS.ConclusionsConventional US, Doppler US and CEUS have a relatively high differential diagnostic value for differentiating between benign and malignant ovarian masses. The diagnostic performance of CEUS was superior to that of conventional US and Doppler US.

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Contrast-Enhanced Transvaginal Sonography of Benign Versus Malignant Ovarian Masses

Journal of Ultrasound in Medicine ◽

10.7863/jum.2008.27.7.1011 ◽

2008 ◽

Vol 27 (7) ◽

pp. 1011-1018 ◽

Cited By ~ 46

Author(s):

Arthur C. Fleischer ◽

Andrej Lyshchik ◽

Howard W. Jones ◽

Marta Crispens ◽

Mary Loveless ◽

...

Keyword(s):

Transvaginal Sonography ◽

Contrast Enhanced ◽

Ovarian Masses

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OC013: Contrast enhanced harmonic transvaginal sonography of morphologically abnormal ovarian masses

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.5421 ◽

2008 ◽

Vol 32 (3) ◽

pp. 247-247

Author(s):

A. C. Fleischer ◽

A. Lyshchik ◽

H. W. Jones III ◽

M. A. Crispens ◽

M. Loveless ◽

...

Keyword(s):

Transvaginal Sonography ◽

Contrast Enhanced ◽

Ovarian Masses

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Postmenopausal Ovarian Cyst

Handbook of Research on Oncological and Endoscopical Dilemmas in Modern Gynecological Clinical Practice - Advances in Medical Diagnosis, Treatment, and Care ◽

10.4018/978-1-7998-4213-2.ch015 ◽

2021 ◽

pp. 207-222

Author(s):

Ioannis Kalogiannidis

Keyword(s):

Ovarian Cancer ◽

Early Diagnosis ◽

Postmenopausal Women ◽

Ovarian Cyst ◽

Daily Practice ◽

Optimal Management ◽

Ovarian Pathology ◽

Adnexal Pathology ◽

Ovarian Masses

Ovarian masses (tumors) are very often in gynaecological daily practice. Almost 5%-10% of the women worldwide receive operative procedures for ovarian pathology. The risk related to ovarian cancer is increased from 3d to 8th decade of woman's life. However, in 80% of the ovarian pathology, the etiology will be of benign origin (cystic, solid, or mixed). The accurate follow-up of patients with adnexal pathology may contribute the early diagnosis of the disease and the improvement of prognosis in a case of malignancy. Optimal management of cysts in postmenopausal women remains challenging. The chapter aims to summarize current clinical evidence regarding diagnosis and treatment of such a pathology.

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Early detection of ovarian cancer

European Radiology ◽

10.1007/s00330-020-06937-z ◽

2020 ◽

Vol 30 (10) ◽

pp. 5370-5373

Author(s):

Rosemarie Forstner

Keyword(s):

Ovarian Cancer ◽

Early Detection ◽

Transvaginal Sonography ◽

Screening Programs ◽

Key Points ◽

Risk Of Malignancy ◽

Predictive Risk ◽

Diagnostic Capabilities ◽

Low Prevalence ◽

Ovarian Masses

Abstract Early detection is the only way to achieve a high cure rate in women with ovarian cancer. Unfortunately, to date, there is no effective strategy for early detection, despite rapidly emerging biomarkers. The low prevalence of ovarian cancer, low specificity and high rates of false positives have been limitations of screening programs. In the hands of experts, transvaginal sonography and MRI are effective tools to characterise ovarian masses. Currently, ongoing efforts in standardization of technique and analysis are likely to improve diagnostic capabilities in clinical routine, as well as the introduction of predictive risk models of malignancy. Radiomics and radiogenomics potentially offer a broad spectrum of complementary information in ovarian cancer diagnosis and treatment. Key Points • Transvaginal sonography and MRI are effective tools to characterise ovarian masses. • Standardisation of imaging technique and implementation of predictive models of risk of malignancy contribute to early detection of ovarian cancer.

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Early Detection of Ovarian Cancer with Conventional and Contrast-Enhanced Transvaginal Sonography: Recent Advances and Potential Improvements

Journal of Oncology ◽

10.1155/2012/302858 ◽

2012 ◽

Vol 2012 ◽

pp. 1-11 ◽

Cited By ~ 9

Author(s):

Arthur C. Fleischer ◽

Andrej Lyshchik ◽

Makiko Hirari ◽

Ryan D. Moore ◽

Richard G. Abramson ◽

...

Keyword(s):

Ovarian Cancer ◽

Doppler Sonography ◽

Early Stage ◽

Color Doppler ◽

Transvaginal Sonography ◽

Sonographic Diagnosis ◽

Contrast Enhanced ◽

Technical Advances ◽

Early Stage Ovarian Cancer

Recently, there have been several major technical advances in the sonographic diagnosis of ovarian cancer in its early stages. These include improved assessment of tumor morphology with transvaginal sonography (TVS), and detection and characterization of tumor neovascularity with transvaginal color Doppler sonography (TV-CDS) and contrast-enhanced transvaginal sonography (CE-TVS). This paper will discuss and illustrate these improvements and describe how they enhance detection of early-stage ovarian cancer. Our initial experience with parametric mapping of CE-TVS will also be mentioned.

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