Early detection of ovarian cancer

Abstract

Early detection is the only way to achieve a high cure rate in women with ovarian cancer. Unfortunately, to date, there is no effective strategy for early detection, despite rapidly emerging biomarkers. The low prevalence of ovarian cancer, low specificity and high rates of false positives have been limitations of screening programs. In the hands of experts, transvaginal sonography and MRI are effective tools to characterise ovarian masses. Currently, ongoing efforts in standardization of technique and analysis are likely to improve diagnostic capabilities in clinical routine, as well as the introduction of predictive risk models of malignancy. Radiomics and radiogenomics potentially offer a broad spectrum of complementary information in ovarian cancer diagnosis and treatment. KEY POINTS: • Transvaginal sonography and MRI are effective tools to characterise ovarian masses. • Standardisation of imaging technique and implementation of predictive models of risk of malignancy contribute to early detection of ovarian cancer.

Keywords: Epithelial ovarian cancer; Magnetic resonance imaging; Ovarian cancer; Radiomics; Screening.

Fig. 1

Mucinous borderline tumour and stage IA invasive ovarian cancer in a 28-year-old female. Coronal T2 (a) demonstrates a large multilocular cystic mass of the right ovary typical of a mucinous tumour. At its superior aspect areas with irregular septations, contrast enhancement (b) and restricted diffusion (c) are demonstrated (arrow). Time intensity curves of the uterus (orange) and solid tissue of the mass (blue) demonstrate type 2 curve with typical initial rise followed by a plateau (d). At histopathology, in this area, foci of invasive cancer were seen