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Genitourinary Imaging |
1 From the Dept of Radiology, Jefferson Medical College and Thomas Jefferson University Hospital, Gibbon Bldg 3350AB, 111 S 11th St, Philadelphia, PA 19107 (A.B.K., R.J.W., D.G.M.); the Dept of Health Care Policy, Harvard Medical School, Boston, Mass (J.V.T., D.J.C., B.J.M.); the Dept of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston (C.M.C.T., S.G.S., D.L.B.); the Depts of Radiology (U.M.H., S.S., J.E.K.) and Pathology (R.J.K.), Johns Hopkins Hospital, Baltimore, Md; the Dept of Radiology, Hospital of the University of Pennsylvania, Philadelphia (P.H.A., E.S.S., B.G.C.); and the Dept of Radiology, University of Michigan Medical Center, Ann Arbor (R.L.B., I.R.F., J.H.E.). Received Jun 26, 1998; revision requested Aug 6; revision received Oct 15; accepted Dec 16. Supported in part by Public Health Service grant U01 CA59401 from the National Cancer Institute. Address reprint requests to A.B.K. (e-mail: alfred.b.kurtz@mail.tju.edu).
PURPOSE: To determine the optimal imaging modality for diagnosis and staging of ovarian cancer.
MATERIALS AND 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%).
CONCLUSION: 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.
Index terms: Computed tomography (CT), comparative studies, 852.1211, 852.12112, 852.12115 • Magnetic resonance (MR), comparative studies, 852.1214, 852.121415, 852.12143 • Ovary, neoplasms, 852.32 • Receiver operating characteristic curve (ROC) • Ultrasound (US), comparative studies, 852.1298 • Ultrasound (US), Doppler studies, 852.12984
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