ARRS 2022 Abstracts

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E1365. Cut to the Chase: Patterns of Tumor Spread and Multi-Modality Imaging of Ovarian Cancer
Authors
  1. Luyao Shen; Stanford University College of Medicine
  2. Andrew Nguyen; Lake Erie College of Osteopathic Medicine
  3. Lindsey Negrete; Stanford University College of Medicine
Background
Ovarian cancer is often diagnosed at a later stage and commonly presents with metastatic disease. Although ovarian cancer is staged by surgery, imaging can help with diagnosis, staging, and surgical planning. It is important for radiologists to learn the patterns of tumor spread in ovarian cancer and places on imaging for a second look to increase diagnostic accuracy.

Educational Goals / Teaching Points
Ovarian cancer is often diagnosed at a later stage and commonly presents with metastatic disease. Many small metastases are easily missed on imaging. Participants will learn the pattern of spread in ovarian cancer with illustrations and imaging as well as the imaging diagnosis and the staging of ovarian cancer with multi-modality imaging and case examples, paying attention to areas of tumor spread that are easily overlooked. We also aim to improve the accuracy of radiology reporting by highlighting some tricks and tips.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Ultrasound is the initial screening tool for ovarian abnormality. The Ovarian-Adnexal Reporting and Data System (O-RADS) is already established to grade ovarian cysts and masses based on the likelihood of malignancy. MRI is the modality of choice for further characterization of ovarian cysts and masses, and it provides the best anatomical evaluation for the pelvis and localized ovarian cancer spread in the pelvis. CT is the preferred imaging staging modality and can help with surgical planning. Many metastatic implants in ovarian cancer can be subtle and easily overlooked. This education exhibit serves to improve reader diagnostic skills. PET/CT can be helpful in determining if lymph nodes are metastatic, and it is complementary to CT for the overall evaluation of metastatic disease.

Conclusion
A staging CT chest, abdomen, and pelvis (CT CAP) examination for ovarian cancer can be overwhelming. We as radiologists can improve our diagnostic skills by understanding how ovarian cancer spreads and what to look for in different stages. We can learn the places that are easily overlooked and pay extra attention to them. With this knowledge and continued accumulation of experience, we can be the imaging experts of ovarian cancer.