Ovarian cancer echocardiography or ultrasound
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Huda A. Karman, M.D.
Overview
Pelvic ultrasound is the first imaging study that should be done to evaluate adnexal mass. The sensitivity and specificity of pelvic ultrasound are 86-91% and 68-83% respectively[1].Ultrasonography helps approaching if the mass could be benign or if it has certain characteristics that increases the probability of being malignant. The specificity of ultrasound in detecting benign masses is high (almost certainly benign). The specificity of ultrasound in detecting malignant masses is low but the sensitivity is high because some may turn out to be malignant after surgical evaluation(a reasonable chance of being malignant)
Echocardiography/Ultrasound
Ovarian cancer can be detected incidentally
- Pelvic ultrasound is the first imaging study that should be done to evaluate adnexal mass (ovary, fallopian tube, surrounding connective tissue)[2]
- The sensitivity and specificity of pelvic ultrasound are 86-91% and 68-83% respectively[1]
- The adnexal mass can present as one of the following
- Pain and pressure
- During physical exam
- Incidentally on pelvic ultrasound
- Ultrasonography helps approaching if the mass could be benign or if it has certain characteristics that increases the probability of being malignant
- The specificity of ultrasound in detecting benign masses is high (almost certainly benign)
- The specificity of ultrasound in detecting malignant masses is low but the sensitivity is high because some may turn out to be malignant after surgical evaluation(a reasonable chance of being malignant)
- Simple roles are used bu IOTA study group to classify adnexal masses finding on ultrasound into:[3]
- Benign adnexal mass findings (B-features ):
- Unilocular cyst
- No solid components and if present, <7 mm in diameter
- Detection of acoustic shadowing
- Multilocular cyst <10 cm in diameter
- No blood flow
- Malignant adnexal mass finding (M-features ):
- Solid irregular component : not hyperechoic, nodular or papillary,
- Detection of peritoneal fluid (ascites)
- Detection of four papillary structures at least
- Irregularly thick septations , >2 to 3 mm.
- irregular solid-multilocular tumor, largest diameter over 10 cm
- Detection of strong flow in the solid component by the color or power doppler
- Detection of peritoneal masses, lymphadenopathy, or matted bowel
References
- ↑ 1.0 1.1 Myers ER, Bastian LA, Havrilesky LJ, Kulasingam SL, Terplan MS, Cline KE; et al. (2006). "Management of adnexal mass". Evid Rep Technol Assess (Full Rep) (130): 1–145. PMC 4781260. PMID 17854238.
- ↑ van Nagell JR, Miller RW (2016). "Evaluation and Management of Ultrasonographically Detected Ovarian Tumors in Asymptomatic Women". Obstet Gynecol. 127 (5): 848–58. doi:10.1097/AOG.0000000000001384. PMID 27054927.
- ↑ Timmerman D, Van Calster B, Testa A, Savelli L, Fischerova D, Froyman W; et al. (2016). "Predicting the risk of malignancy in adnexal masses based on the Simple Rules from the International Ovarian Tumor Analysis group". Am J Obstet Gynecol. 214 (4): 424–437. doi:10.1016/j.ajog.2016.01.007. PMID 26800772. Review in: Evid Based Med. 2016 Oct;21(5):197