Abstract
We have carried out a prospective study on the impact of computed tomography (CT) and ultrasonography (US) on the management of patients with carcinoma of the ovary. Seventy-eight CT and 88 US scans were performed on 94 patients. Clinicians decided patient management prospectively at the time the CT and/or US was ordered. Clinical assessment differed from the result obtained by CT or US in 45% of cases (35/78 and 40/88, respectively). CT and US altered patient management in only a minority of cases (14/78, 18% and 9/88, 10% respectively). Even when the scan and clinical assessments differed, management was only altered on 14/35 (40%) occasions after CT and on 9/40 (23%) occasions after US, a difference which was not significant. In patients with clinically undetectable disease, management was altered by CT on 17% of occasions and by US on 10%. We conclude that in patients with carcinoma of the ovary CT and US alters patient management in a minority of cases. In view of current financial restrictions in health care, clinicians should be more selective in the use of these imaging techniques. Furthermore, we recommend that similar prospective studies are performed for other clinical situations.
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Selected References
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- Bernardino M. E., Jing B. S., Wallace S. Computed tomography diagnosis of mesenteric masses. AJR Am J Roentgenol. 1979 Jan;132(1):33–36. doi: 10.2214/ajr.132.1.33. [DOI] [PubMed] [Google Scholar]
- Johnson R. J., Blackledge G., Eddleston B., Crowther D. Abdomino-pelvic computed tomography in the management of ovarian carcinoma. Radiology. 1983 Feb;146(2):447–452. doi: 10.1148/radiology.146.2.6849092. [DOI] [PubMed] [Google Scholar]
- Kerr-Wilson R. H., Shingleton H. M., Orr J. W., Jr, Hatch K. D. The use of ultrasound and computed tomography scanning in the management of gynecologic cancer patients. Gynecol Oncol. 1984 May;18(1):54–61. doi: 10.1016/0090-8258(84)90006-4. [DOI] [PubMed] [Google Scholar]
- Khan O., Cosgrove D. O., Fried A. M., Savage P. E. Ovarian carcinoma follow-up: US versus laparotomy. Radiology. 1986 Apr;159(1):111–113. doi: 10.1148/radiology.159.1.3513245. [DOI] [PubMed] [Google Scholar]
- Levitt R. G., Sagel S. S., Stanley R. J. Detection of neoplastic involvement of the mesentery and omentum by computed tomography. AJR Am J Roentgenol. 1978 Nov;131(5):835–838. doi: 10.2214/ajr.131.5.835. [DOI] [PubMed] [Google Scholar]
- Miller A. B., Hoogstraten B., Staquet M., Winkler A. Reporting results of cancer treatment. Cancer. 1981 Jan 1;47(1):207–214. doi: 10.1002/1097-0142(19810101)47:1<207::aid-cncr2820470134>3.0.co;2-6. [DOI] [PubMed] [Google Scholar]
- Nash C. H., 3rd, Alberts D. S., Suciu T. N., Giles H. R., Tobias D. A., Waldman R. S. Comparison of B-mode ultrasonography and computed tomography in gynecologic cancer. Gynecol Oncol. 1979 Oct;8(2):172–179. doi: 10.1016/0090-8258(79)90022-2. [DOI] [PubMed] [Google Scholar]
- Paling M. R., Shawker T. H. Abdominal ultrasound in advanced ovarian carcinoma. J Clin Ultrasound. 1981 Oct;9(8):435–441. doi: 10.1002/jcu.1870090807. [DOI] [PubMed] [Google Scholar]
- Robbins A. H., Pugatch R. D., Gerzof S. G., Faling L. J., Johnson W. C., Sewell D. H. Observations on the medical efficacy of computed tomography of the chest and abdomen. AJR Am J Roentgenol. 1978 Jul;131(1):15–19. doi: 10.2214/ajr.131.1.15. [DOI] [PubMed] [Google Scholar]
- Sonnendecker E. W., Butterworth A. M. Comparison between ultrasound and histopathological evaluation in ovarian cancer patients with complete clinical remission. J Clin Ultrasound. 1985 Jan;13(1):5–9. doi: 10.1002/jcu.1870130103. [DOI] [PubMed] [Google Scholar]
- Stern J., Buscema J., Rosenshein N., Siegelman S. Can computed tomography substitute for second-look operation in ovarian carcinoma? Gynecol Oncol. 1981 Feb;11(1):82–88. doi: 10.1016/0090-8258(81)90012-3. [DOI] [PubMed] [Google Scholar]
- Whitley N., Brenner D., Francis A., Kwon T., Villasanta U., Aisner J., Wiernik P., Whitley J. Use of the computed tomographic whole body scanner to stage and follow patients with advanced ovarian carcinoma. Invest Radiol. 1981 Nov-Dec;16(6):479–486. doi: 10.1097/00004424-198111000-00005. [DOI] [PubMed] [Google Scholar]
- Wicks J. D., Mettler F. A., Jr, Hilgers R. D., Ampuero F. Correlation of ultrasound and pathologic findings in patients with epithelial carcinoma of the ovary. J Clin Ultrasound. 1984 Sep;12(7):397–402. doi: 10.1002/jcu.1870120704. [DOI] [PubMed] [Google Scholar]
- Wittenberg J., Fineberg H. V., Ferrucci J. T., Jr, Simeone J. F., Mueller P. R., vanSonnenberg E., Kirkpatrick R. H. Clinical efficacy of computed body tomography, II. AJR Am J Roentgenol. 1980 Jun;134(6):1111–1120. doi: 10.2214/ajr.134.6.1111. [DOI] [PubMed] [Google Scholar]
