scholarly journals Comparison of conventional, doppler and contrast-enhanced ultrasonography in differential diagnosis of ovarian masses: a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e052830
Author(s):  
Lizhang Xun ◽  
Lamei Zhai ◽  
Hui Xu
Keyword(s):  
Systematic Review ◽  
Ovarian Cancer ◽  
Data Extraction ◽  
Meta Analysis ◽  
Diagnostic Value ◽  
Doppler Us ◽  
Contrast Enhanced ◽  
Contrast Enhanced Ultrasonography ◽  
Sensitivity Specificity ◽  
Ovarian Masses

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.

scholarly journals Conventional, Doppler and Contrast-Enhanced Ultrasonography in Differential Diagnosis of Ovarian Masses

2016 ◽  
Vol 39 (6) ◽  
pp. 2398-2408 ◽  
Author(s):  
Zongyu Liu ◽  
Fan Yang ◽  
Yong Zhang ◽  
Huimei Yu ◽  
He Zhu ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Sensitivity And Specificity ◽  
Malignant Tumors ◽  
Meta Analysis ◽  
Diagnostic Value ◽  
Likelihood Ratios ◽  
Doppler Us ◽  
Contrast Enhanced ◽  
Contrast Enhanced Ultrasonography ◽  
Ovarian Masses

Background: Differential diagnosis of ovarian masses can influence both treatment selection and prognosis of ovarian tumor patients. A comprehensive review was performed with respect to the diagnostic value of conventional ultrasonography, Doppler ultrasonography and contrast-enhanced ultrasonography (CEUS) in differentiating benign from malignant ovarian masses. Methods: Databases were searched for relevant articles. Retrieved studies were screened according to the inclusion criteria. Pooled statistics including specificity, sensitivity, positive likelihood ratios (PLR), negative likelihood ratios (NLR), diagnostic odds ratio (DOR) and area under curve (AUC) were utilized to calculate the overall diagnostic value for each diagnostic approach. Results: Sixty-seven high quality articles were finally enrolled in the present meta-analysis. The sensitivity and specificity of conventional US were 0.92 and 0.86, respectively. The corresponding sensitivity and specificity of Doppler US were 0.93 and 0.85, respectively. Additionally, these figures for CEUS were 0.97 and 0.92, respectively. Finally, the AUC values for conventional US, Doppler US and CEUS were 0.95, 0.96 and 0.99, respectively. Conclusion: All of the three US-related imaging modalities have relatively high diagnostic value in distinguishing malignant tumors from benign ones in ovarian tumors.

scholarly journals Diagnostic value of [18F]FDG PET/MRI for staging in patients with ovarian cancer

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Hideaki Tsuyoshi ◽  
Tetsuya Tsujikawa ◽  
Shizuka Yamada ◽  
Hidehiko Okazawa ◽  
Yoshio Yoshida
Keyword(s):  
Ovarian Cancer ◽  
Fdg Pet ◽  
Diagnostic Value ◽  
Mri Contrast ◽  
Diagnostic Potential ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Imaging Results ◽  
N Stage ◽  
Sensitivity Specificity

Abstract Purpose To evaluate the diagnostic potential of PET/MRI with 2-[18F]fluoro-2-deoxy-d-glucose ([18F]FDG) in ovarian cancer. Materials and methods Participants comprised 103 patients with suspected ovarian cancer underwent pretreatment [18F]FDG PET/MRI, contrast-enhanced CT (ceCT) and pelvic dynamic contrast-enhanced MRI (ceMRI). Diagnostic performance of [18F]FDG PET/MRI and ceMRI for assessing the characterization and the extent of the primary tumor (T stage) and [18F]FDG PET/MRI and ceCT for assessing nodal (N stage) and distant (M stage) metastases was evaluated by two experienced readers. Histopathological and follow-up imaging results were used as the gold standard. The McNemar test was employed for statistical analysis. Results Accuracy for the characterization of suspected ovarian cancer was significantly better for [18F]FDG PET/MRI (92.5%) [95% confidence interval (CI) 0.84–0.95] than for ceMRI (80.6%) (95% CI 0.72–0.83) (p < 0.05). Accuracy for T status was 96.4% (95% CI 0.96–0.96) and 92.9% (95% CI 0.93–0.93) for [18F]FDG PET/MRI and ceMRI/ceCT, respectively. Patient-based accuracies for N and M status were 100% (95% CI 0.88–1.00) and 100% (95% CI 0.88–1.00) for [18F]FDG PET/MRI and 85.2% (95% CI 0.76–0.85) and 30.8% (95% CI 0.19–0.31) for ceCT and M staging representing significant differences (p < 0.01). Lesion-based sensitivity, specificity and accuracy for N status were 78.6% (95% CI 0.57–0.91), 95.7% (95% CI 0.93–0.97) and 93.9% (95% CI 0.89–0.97) for [18F]FDG PET/MRI and 42.9% (95% CI 0.24–0.58), 96.6% (95% CI 0.94–0.98) and 90.8% (95% CI 0.87–0.94) for ceCT. Conclusions [18F]FDG PET/MRI offers better sensitivity and specificity for the characterization and M staging than ceMRI and ceCT, and diagnostic value for T and N staging equivalent to ceMRI and ceCT, suggesting that [18F]FDG PET/MRI might represent a useful diagnostic alternative to conventional imaging modalities in ovarian cancer.

scholarly journals Mesothelin as a biomarker for ovarian carcinoma: a meta-analysis

2016 ◽  
Vol 88 (2) ◽  
pp. 923-932 ◽  
Author(s):  
KRISTIAN MADEIRA ◽  
EDUARDO R. DONDOSSOLA ◽  
BRUNA F. DE FARIAS ◽  
CARLA S. SIMON ◽  
MARIA C.M. ALEXANDRE ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ovarian Cancer ◽  
Ovarian Tissue ◽  
Meta Analysis ◽  
Diagnostic Odds Ratio ◽  
Cochrane Central Register ◽  
Central Register ◽  
Quantitative Systematic Review ◽  
Comprehensive Search ◽  
Sensitivity Specificity

The objective of this work was to estimate the accuracy of mesothelin as a biomarker for ovarian cancer. A quantitative systematic review was performed. A comprehensive search of the Medline, LILACS, SCOPUS, Embase, Cochrane Central Register of Controlled Trials, Biomed Central, and ISI Web of Science databases was conducted from January 1990 to June 2015. For inclusion in this systematic review, the papers must have measured mesothelin levels in at least two histological diagnoses; ovarian cancer (borderline or ovarian tumor) vs. benign or normal ovarian tissue. For each study, 2 x 2 contingency tables were constructed. We calculated the sensitivity, specificity and diagnostic odds ratio. The verification bias was performed according to QUADAS-2. Statistical analysis was performed with the software Stata 11, Meta-DiSc(r) and RevMan 5.2. Twelve studies were analyzed, which included 1,561 women. The pooled sensitivity was 0.62 (CI 95% 0.58 - 0.66) and specificity was 0.94 (CI 95% 0.92 - 0.95). The DOR was 38.92 (CI 95% 17.82 - 84.99). Our systematic review shows that mesothelin cannot serve alone as a biomarker for the detection of ovarian cancer.

scholarly journals Diagnostic Value of Osteopontin in Ovarian Cancer: A Meta-Analysis and Systematic Review

PLoS ONE ◽  
2015 ◽  
Vol 10 (5) ◽  
pp. e0126444 ◽  
Author(s):  
Zhi-De Hu ◽  
Ting-Ting Wei ◽  
Min Yang ◽  
Ning Ma ◽  
Qing-Qin Tang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ovarian Cancer ◽  
Meta Analysis ◽  
Diagnostic Value

scholarly journals Diagnostic value of [18F]FDG PET/MRI for staging in patients with ovarian cancer

2020 ◽  
Author(s):  
Hideaki Tsuyoshi ◽  
Tetsuya Tsujikawa ◽  
Shizuka Yamada ◽  
Hidehiko Okazawa ◽  
Yoshio Yoshida
Keyword(s):  
Ovarian Cancer ◽  
Fdg Pet ◽  
Diagnostic Value ◽  
Mri Contrast ◽  
Diagnostic Potential ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Imaging Results ◽  
N Stage ◽  
Sensitivity Specificity

Abstract Purpose: To evaluate the diagnostic potential of PET/MRI with 2-[18F]fluoro-2-deoxy-D-glucose ([18F]FDG) in ovarian cancer.Materials and Methods: Participants comprised 103 patients with suspected ovarian cancer underwent pretreatment [18F]FDG PET/MRI, contrast-enhanced CT (ceCT) and pelvic dynamic contrast-enhanced MRI (ceMRI). Diagnostic performance of [18F]FDG PET/MRI and ceMRI for assessing the characterization and the extent of the primary tumor (T stage) and [18F]FDG PET/MRI and ceCT for assessing nodal (N stage) and distant (M stage) metastases was evaluated by two experienced readers. Histopathological and follow-up imaging results were used as the gold standard. The McNemar test was employed for statistical analysis.Results: Accuracy for the characterization of suspected ovarian cancer was significantly better for [18F]FDG PET/MRI (92.5%) [95% confidence interval (CI) 0.84–0.95] than for ceMRI (80.6%) (95%CI 0.72–0.83) (p <0.05). Accuracy for T status was 96.4% (95%CI 0.96–0.96) and 92.9% (95%CI 0.93–0.93) for [18F]FDG PET/MRI and ceMRI/ceCT, respectively. Patient-based accuracies for N and M status were 100% (95%CI 0.88–1.00) and 100% (95%CI 0.88–1.00) for [18F]FDG PET/MRI and 85.2% (95%CI 0.76–0.85) and 30.8% (95%CI 0.19–0.31) for ceCT and M staging representing significant differences (p<0.01). Lesion-based sensitivity, specificity and accuracy for N status were 78.6% (95%CI 0.57–0.91), 95.7% (95%CI 0.93–0.97) and 93.9% (95%CI 0.89–0.97) for [18F]FDG PET/MRI and 42.9% (95%CI 0.24–0.58), 96.6% (95%CI 0.94–0.98) and 90.8% (95%CI 0.87–0.94) for ceCT. Conclusions: [18F]FDG PET/MRI offers better sensitivity and specificity for the characterization and M staging than ceMRI and ceCT, and diagnostic value for T and N staging equivalent to ceMRI and ceCT, suggesting that [18F]FDG PET/MRI might represent a useful diagnostic alternative to conventional imaging modalities in ovarian cancer.

scholarly journals Efficacy and Safety of PARP Inhibitor Combination Therapy in Recurrent Ovarian Cancer: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Ning Ren ◽  
Leyin Zhang ◽  
Jieru Yu ◽  
Siqi Guan ◽  
Xinyang Dai ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ovarian Cancer ◽  
Combination Therapy ◽  
Data Extraction ◽  
Meta Analysis ◽  
Parp Inhibitor ◽  
Recurrent Ovarian Cancer ◽  
Parp Inhibitors ◽  
High Grade ◽  
Efficacy And Safety

ObjectivesThough it is known to all that PARP inhibitors (PARPis) are effective when used as maintenance alone for women with recurrent ovarian cancer (ROC), little is known about whether using them in combination with other drugs would contribute to a better efficacy. We performed a systematic review and meta-analysis to explore the efficacy and safety of PARPi combination therapy compared with monotherapy.Materials and MethodsWe searched for randomized controlled trials (RCTs) that offered the date we needed in PubMed, Embase, Cochrane, and major conference. Data extraction and processing were completed by three investigators to compare OS, PFS, and ORR both in intervention and in control subset. Then, we calculated the pooled RR and 95% CI of all-grade and high-grade adverse effects to study its safety. And we evaluated the within-study heterogeneity by using subgroup and sensitivity analysis.Results and ConclusionA total of three eligible RCTs covering 343 women were included. In PFS analysis, PARP inhibitor (PARPi) combination therapy can significantly improve PFS for women with ROC when compared with the controls (HR: 0.46, 95% CI: 0.35 to 0.59), especially for those with mutated BRCA (HR: 0.29, 95% CI: 0.19 to 0.45). And in OS analysis, combination therapy is not inferior to monotherapy (HR: 0.90, 95% CI: 0.50 to 1.61). As for ORR, the effectiveness of combination therapy and monotherapy was almost the same (RR: 1.04, 95% CI: 0.82 to 1.31). Additionally, combination therapy seldom causes more adverse events, both in all-grade and in high grade.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, International Prospective Register of Systematic Reviews (PROSPERO) (identifier, CRD42018109933).

Diagnostic Value of Serum Human Epididymis Protein 4 (HE4) in Ovarian Carcinoma: A Systematic Review and Meta-Analysis

2012 ◽  
Vol 22 (7) ◽  
pp. 1106-1112 ◽  
Author(s):  
Li Wu ◽  
Zhi-Yuan Dai ◽  
Yong-Hong Qian ◽  
Yan Shi ◽  
Feng-Ju Liu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ovarian Cancer ◽  
Ovarian Carcinoma ◽  
Sensitivity And Specificity ◽  
Meta Analysis ◽  
Diagnostic Value ◽  
Control Group ◽  
Human Epididymis Protein 4 ◽  
Human Epididymis ◽  
Pelvic Masses

ObjectiveHuman epididymis protein 4 (HE4), a precursor of human epididymis protein, has been recently identified as a new promising serum biomarker for ovarian carcinoma. We performed a systematic review of studies that investigated the use of HE4 in the diagnosis of ovarian cancer in patients with pelvic or gynecological masses. We also evaluated the diagnostic performance of HE4 for differentiating between patients with benign gynecological disease and those with ovarian cancer.MethodsWe searched PubMed database (1990–2011) to collect articles in English that evaluated the diagnostic value of HE4 in patients with gynecological or pelvic masses. Two reviewers independently assessed the methodological quality of each study using the quality assessment of diagnostic accuracy studies tool. The data were analyzed using Meta-Disc1.4 software. Meta-analysis of the reported sensitivity and specificity of each study and summary receiver operating characteristic (SROC) curve were performed.ResultsA total of 9 studies involving 1807 women were included. When the control group was composed of healthy women, the pooled sensitivity and specificity for HE4 in diagnosing ovarian cancer were 83% (95% confidence interval [CI], 77%–88%) and 90% (95% CI, 87%–92%), respectively. The area under the SROC curve was 0.9271. When the control group was composed of women with benign disease, the pooled sensitivity and specificity for HE4 were 74% (95% CI, 69%–78%) and 90% (95% CI, 87%–92%). The area under the SROC curve was 0.8853.ConclusionThe current analysis indicated that HE4 may be a valuable marker in the diagnosis of ovarian carcinoma. Serum HE4 detection is not only a useful preoperative test for predicting the benign or malignant nature of pelvic masses but has a potential to be used as an initial step in ovarian cancer screening strategy.

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