Diagnosis and staging of ovarian cancer: comparative values of Doppler and conventional US, CT, and MR imaging correlated with surgery and histopathologic analysis--report of the Radiology Diagnostic Oncology Group.
OBJECTIVE
To determine the optimal imaging modality for diagnosis and staging of ovarian cancer.


METHODS
Two hundred eighty women suspected to have ovarian cancer were enrolled in a prospective study before surgery. Doppler ultrasonography (US), computed tomography (CT), and magnetic resonance (MR) imaging were used to evaluate the mass; conventional US, CT, and MR imaging were used to stage spread.


RESULTS
All three modalities had high accuracy (0.91) for the overall diagnosis of malignancy. In the ovaries, the accuracy of MR imaging (0.91) was higher than that of CT and significantly higher than that of Doppler US (0.78). In the extraovarian pelvis and in the abdomen, conventional US, CT, and MR imaging had similar accuracies (0.87-0.95). In differentiation of disease confined to the pelvis from abdominal spread, the specificity of conventional US (96%) was higher than that of CT and significantly higher than that of MR imaging (88%), whereas the sensitivities of MR imaging (98%) and CT (92%) were significantly higher than that of conventional US (75%).


CONCLUSIONS
MR imaging is superior to Doppler US and CT in diagnosis of malignant ovarian masses. There is little variation among conventional US, CT, and MR imaging as regards staging.
Dept of Radiology, Jefferson Medical College, Philadelphia, PA, USA. alfred.b.kurtz@mail.tju.edu
A B
AB
Kurtz
J V
JV
Tsimikas
C M
CM
Tempany
U M
UM
Hamper
P H
PH
Arger
R L
RL
Bree
R J
RJ
Wechsler
I R
IR
Francis
J E
JE
Kuhlman
E S
ES
Siegelman
D G
DG
Mitchell
S G
SG
Silverman
D L
DL
Brown
S
S
Sheth
B G
BG
Coleman
J H
JH
Ellis
R J
RJ
Kurman
D J
DJ
Caudry
B J
BJ
McNeil
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D010053:Ovary / Q000473:pathology; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D018608:Ultrasonography, Doppler