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Luis Alcázar J, Ramón Pérez-Vidal J, Tameish S, Chacón E, Manzour N, Ángel Mínguez J. Ultrasound for assessing tumor spread in ovarian cancer. A systematic review of the literature and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2024; 292:194-200. [PMID: 38042117 DOI: 10.1016/j.ejogrb.2023.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 11/07/2023] [Accepted: 11/14/2023] [Indexed: 12/04/2023]
Abstract
In this review, we aimed to assess the diagnostic performance of ultrasound for assessing the tumor spread in the abdomen in women with ovarian cancer. A search for studies evaluating the role of ultrasound for assessing intrabdominal tumor spread in women with ovarian cancer compared to surgery from January 2011 to March 2023 was performed in PubMed/MEDLINE, Web of Science, and Scopus databases. The Quality Assessment of Diagnostic Accuracy Studies 2 evaluated the quality of the studies (QUADAS-2). All analyses were performed using MIDAS and METANDI commands in STATA 12.0 software. We identified 1552 citations. After exclusions, five studies comprising 822 women were included. Quality of studies were considered as good, except for patient selection as all studies were considered as having high risk of bias. The pooled sensitivity and specificity could be calculated for three anatomical areas (recto-sigma, major omentum and root of mesentery) and the presence of ascites. The pooled sensitivity and specificity for detecting disease in the recto-sigma, major omentum and root of mesentery were 0.83 and 0.95, 0.87 and 0.87, and 0.29 and 0.99, respectively. The pooled sensitivity and specificity for detecting ascites was 0.95 and 0.91, respectively. There is evidence that ultrasound offers good diagnostic performance for evaluating the intra-abdominal extent of disease in women with suspected ovarian cancer.
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Affiliation(s)
- Juan Luis Alcázar
- Department of Obstetrics and Gynecology, Clinica Universidad de Navarra, 31008 Pamplona, Spain.
| | - Juan Ramón Pérez-Vidal
- Department Obstetrics and Gynecology, University Hospital Virgen de la Arrixaca, 31120 El Palmar, Murcia, Spain
| | - Sarah Tameish
- Department of Obstetrics and Gynecology, University Hospital Sant Joan, 43204 Reus, Spain
| | - Enrique Chacón
- Department of Obstetrics and Gynecology, Clinica Universidad de Navarra, 31008 Pamplona, Spain
| | - Nabil Manzour
- Department of Obstetrics and Gynecology, Clinica Universidad de Navarra, 31008 Pamplona, Spain
| | - José Ángel Mínguez
- Department of Obstetrics and Gynecology, Clinica Universidad de Navarra, 31008 Pamplona, Spain
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Pavlik EJ, Brekke E, Gorski J, Baldwin-Branch L, Miller R, DeSimone CP, Dietrich CS, Gallion HS, Ueland FR, van Nagell JR. Ultrasonographic Visualization of the Ovaries to Detect Ovarian Cancer According to Age, Menopausal Status and Body Type. Diagnostics (Basel) 2022; 12:diagnostics12010128. [PMID: 35054294 PMCID: PMC8775241 DOI: 10.3390/diagnostics12010128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/28/2021] [Accepted: 01/03/2022] [Indexed: 11/16/2022] Open
Abstract
Because the effects of age, menopausal status, weight and body mass index (BMI) on ovarian detectability by transvaginal ultrasound (TVS) have not been established, we determined their contributions to TVS visualization of the ovaries. A total of 29,877 women that had both ovaries visualized on their first exam were followed over 202,639 prospective TVS exams. All images were reviewed by a physician. While visualization of both ovaries decreased with age, one or both ovaries could be visualized in two of every three women over 80 years of age. Around 93% of pre-menopausal women and ~69% of post-menopausal women had both ovaries visualized. Both ovaries were visualized in ~72% of women weighing over 300 lbs. and in ~70% of women with a BMI over 40. Conclusions: Age had the greatest influence on the visualization of the ovaries. The ovaries can be visualized well past the menopause. Body habitus was not limiting to TVS ovarian imaging, and TVS should be considered capable of imaging one or both ovaries in two of every three women over 80 years of age. Thus, older and obese patients remain good candidates for TVS exams.
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Affiliation(s)
- Edward J. Pavlik
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky Chandler Medical Center-Markey Cancer Center, Lexington, KY 40536-0293, USA; (J.G.); (L.B.-B.); (R.M.); (C.P.D.); (C.S.D.); (H.S.G.); (F.R.U.); (J.R.v.N.J.)
- Correspondence: ; Tel.: +1-859-321-9313
| | - Emily Brekke
- Department of Obstetrics and Gynecology, University of Kansas Medical Center, Kansas City, KS 66160, USA;
| | - Justin Gorski
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky Chandler Medical Center-Markey Cancer Center, Lexington, KY 40536-0293, USA; (J.G.); (L.B.-B.); (R.M.); (C.P.D.); (C.S.D.); (H.S.G.); (F.R.U.); (J.R.v.N.J.)
| | - Lauren Baldwin-Branch
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky Chandler Medical Center-Markey Cancer Center, Lexington, KY 40536-0293, USA; (J.G.); (L.B.-B.); (R.M.); (C.P.D.); (C.S.D.); (H.S.G.); (F.R.U.); (J.R.v.N.J.)
| | - Rachel Miller
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky Chandler Medical Center-Markey Cancer Center, Lexington, KY 40536-0293, USA; (J.G.); (L.B.-B.); (R.M.); (C.P.D.); (C.S.D.); (H.S.G.); (F.R.U.); (J.R.v.N.J.)
| | - Christopher P. DeSimone
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky Chandler Medical Center-Markey Cancer Center, Lexington, KY 40536-0293, USA; (J.G.); (L.B.-B.); (R.M.); (C.P.D.); (C.S.D.); (H.S.G.); (F.R.U.); (J.R.v.N.J.)
| | - Charles S. Dietrich
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky Chandler Medical Center-Markey Cancer Center, Lexington, KY 40536-0293, USA; (J.G.); (L.B.-B.); (R.M.); (C.P.D.); (C.S.D.); (H.S.G.); (F.R.U.); (J.R.v.N.J.)
| | - Holly S. Gallion
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky Chandler Medical Center-Markey Cancer Center, Lexington, KY 40536-0293, USA; (J.G.); (L.B.-B.); (R.M.); (C.P.D.); (C.S.D.); (H.S.G.); (F.R.U.); (J.R.v.N.J.)
| | - Frederick Rand Ueland
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky Chandler Medical Center-Markey Cancer Center, Lexington, KY 40536-0293, USA; (J.G.); (L.B.-B.); (R.M.); (C.P.D.); (C.S.D.); (H.S.G.); (F.R.U.); (J.R.v.N.J.)
| | - John R. van Nagell
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky Chandler Medical Center-Markey Cancer Center, Lexington, KY 40536-0293, USA; (J.G.); (L.B.-B.); (R.M.); (C.P.D.); (C.S.D.); (H.S.G.); (F.R.U.); (J.R.v.N.J.)
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