Catching Ovarian Cancer

Posted on January 2016

Elizabeth Sadowski, MD, has always placed a great deal of importance on addressing women’s health issues through imaging. The imaging appearance of ovarian cancer is a particular interest of hers, and she spent much of this year’s Radiologic Society of North America (RSNA) annual conference focused on educating radiologists about the topic.

In an interactive session, Dr. Sadowski joined international colleagues in presenting a refresher course entitled, “Characterization of Complex and Sonographically Indeterminate Adnexal Masses.” The group led the audience through the typical appearance of benign and neoplastic ovarian lesions on MRI, zeroing in on signal characteristics and enhancement patterns. Referring gynecologists consider MRI the non-surgical gold standard and it is increasingly becoming part of the work-up of ovarian lesions discovered on ultrasound.

Dr. Sadowski continued with “Catching Ovarian Cancer” during the “Essentials of Genitourinary Imaging” course, teaching the audience how to spot early ovarian cancer on ultrasound, CT, and MRI. Early detection requires an understanding of the differing development of low-grade versus high-grade tumors, in order to correctly prescribe a course of action. Dr. Sadowski reviewed the imaging features of benign, intermediate, and worrisome lesions, and discussed the appropriate follow-up in each case.

Lastly, Dr. Sadowski presented during the Gynecological Diseases scientific session. Her presentation entitled, “Cystic Adnexal Lesions Analyzed International Ovarian Tumor Analysis (IOTA) Criteria in Routine Clinical Practice,” summarized preliminary work on the performance of the IOTA simple rules in catching ovarian cancers. Dr. Sadowski, along with UW colleagues Jessica Robbins, M.D., and Department of Medicine’s Lisa Barroilhet, M.D., led a research group testing the accuracy of existing criteria in characterizing ovarian lesions on ultrasound. The results of the study indicated that the IOTA simple rules were successful in detecting both benign and malignant tumors, although the group noted that a, “full and nuanced evaluation of diagnostic performance will require a larger number of cancers to be evaluated.” In the future, the group hopes to compare the IOTA simple rules to the Society of Radiologists in Ultrasound ovarian cyst management guidelines to determine the relative performance of the two systems.