Value of preoperative transvaginal sonography (TVS) in the description of tumor pattern in ovarian cancer patients: results of a prospective study.
BACKGROUND
This prospective study evaluates the predictive value of preoperative staging by transvaginal sonography (TVS) in ovarian cancer.


METHODS
In 39 patients presenting with clinical signs and symptoms of ovarian cancer, preoperative systematic staging regarding tumor size (T), presence of ascites (A), peritoneal carcinomatosis (PC), bladder invasion (BI), intestinal invasion (II) as well as pelvic lymph node involvement (LN), were evaluated by TVS. Findings combining conventional B-mode ultrasound and Color Doppler imaging were compared to preoperative findings and final histology results.


RESULTS
Preoperative staging was correctly achieved by TVS for T in 87%, for A in 97% (95% CI: 90-100), for PC in 96% (95% CI: 86-100), for BI in 99% (95% CI: 95-100), for II in 98% (95% CI: 93-100). The predictive value of TVS for LN was minor (sensitivity: 8%, 95% CI: 7-24).


CONCLUSIONS
TVS is a sensitive and noninvasive method for preoperative staging of suspected ovarian cancer regarding tumor size, ascites, invasion of adjacent organs and peritoneal carcinomatosis, but not for detection of malignant lymph nodes. The need for invasive or more elaborate diagnostic tools such as CT and MRI, cystoscopy, rectoscopy and diagnostic ascites punction can potentially be reduced by systematic use of TVS.
Henrich
Wolfgang
W
Department of Obstetrics and Gynecology, Campus Virchow Clinic, Berlin, Germany. wolfgang.henrich@charite.de
Fotopoulou
Christina
C
Fuchs
Ilka
I
Wolf
Claudia
C
Schmider
Annette
A
Denkert
Carsten
C
Lichtenegger
Werner
W
Sehouli
Jalid
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000000981:diagnostic imaging / Q000473:pathology; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011446:Prospective Studies; D018615:Ultrasonography, Doppler, Color