Value of preoperative transvaginal sonography (TVS) in the description of tumor pattern in ovarian cancer patients: results of a prospective study

Abstract

Background: This prospective study evaluates the predictive value of preoperative staging by transvaginal sonography (TVS) in ovarian cancer.

Patients and 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).

Conclusion: 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.