Comparison of Key Sites Tumor Expansion on Imaging with Surgical Findings in Advanced Stage Ovarian Malignancy

Tofan Widya Utami, Henny M.A.R. Putri, Aria Kekalih and Sahat B. Matondang

Background and Objective: A number of key sites can be defined that are particularly involved and determined outcome of surgery. Pre-operative evaluation by advanced imaging (computed tomography/CT-scan or magnetic resonance imaging/MRI) is essential to plan. The objective of the study was to correlate the pre-operative CT-scan or MRI results to intraoperative findings. Materials and Methods: This was an observational study to correlate key sites of advanced ovarian epithelial cancer with intra operative. After ethical approval, imaging and operative data were obtained from medical record. Results: Sixty patients with advanced ovarian cancer were included in the study. Patients had CT-scan (75.0%) and MRI (25.0%). All patients were FIGO stage III and above during the operation. Analysis showed there were four key features that associated with the images significantly, mass at porta hepatis/gall bladder, massive ascites, lesion on subcapsular or intraparenchymal liver and large omental cake. Accuracy for the significant features was range between 65-81%. The specificity of the advanced imaging results was good all across the key sites but the sensitivity was considerably low. In the contrary, the sensitivity of images involving gastrointestinal tract was better than the sensitivity of lymph nodes involvement. Conclusion: Advanced imaging was specific in detecting epithelial ovarian malignancy spread pre-operatively although they were considerably low in sensitivity. Except, this study reported the high sensitivity and low specificity from the images of GI tract involvement. However, scrutinizing the advanced imaging findings systematically will benefit for surgical approach in particular for interdepartmental surgeon team.

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