The sensitivity varies by anatomic site, however, and the most important limitation of CT in staging ovarian cancer is its inability to reliably detect bowel surface, mesenteric, or peritoneal tumor implants <5 mm, especially in the absence of ascites [5,43,58,59]. CT is also useful for guiding biopsy of the omentum, or other abdominal tumor, a procedure that can increase the accuracy of preoperative diagnosis, if indicated [60-63]. For assessment of the resectability of ovarian cancer, cross-sectional imaging (CT or MRI) plays a critically important role in finding significant lesions (>2 cm) at the root of the mesentery, gastrosplenic ligament, omentum of the lesser sac, porta hepatis, intersegmental fissure of the liver, diaphragm, liver dome, and lung parenchyma, and also in detecting lymphadenopathy at or above the celiac axis, presacral extraperitoneal disease, and pelvic sidewall invasion [5,14,40,52,64-68]. Incomplete resection (residual tumor >1 cm) of primary tumor Staging and Follow-up of Ovarian Cancer yields little survival benefit while subjecting patients to substantial perioperative morbidity. To date, imaging and prediction models that are based on imaging, demographic characteristics, and tumor markers have not been shown to provide sufficiently high accuracy for prediction of suboptimal debulking to guide the decision regarding surgery [55,69]. Unresectable disease can be managed by needle or laparoscopic biopsy, followed by chemotherapy, and possibly by a later attempt at interval debulking, resulting in improved survival by virtue of response to chemotherapy and optimal resection [9,34,60-63]. Noncontrast-enhanced CT of the abdomen and pelvis offers limited ability to differentiate small peritoneal or mesenteric implants, or lymphadenopathy, from bowel or other adjacent organs. CT Chest CT of the chest is useful for detecting pleural and pulmonary metastases during primary staging.
Staging and Follow up of Ovarian Cancer. The sensitivity varies by anatomic site, however, and the most important limitation of CT in staging ovarian cancer is its inability to reliably detect bowel surface, mesenteric, or peritoneal tumor implants <5 mm, especially in the absence of ascites [5,43,58,59]. CT is also useful for guiding biopsy of the omentum, or other abdominal tumor, a procedure that can increase the accuracy of preoperative diagnosis, if indicated [60-63]. For assessment of the resectability of ovarian cancer, cross-sectional imaging (CT or MRI) plays a critically important role in finding significant lesions (>2 cm) at the root of the mesentery, gastrosplenic ligament, omentum of the lesser sac, porta hepatis, intersegmental fissure of the liver, diaphragm, liver dome, and lung parenchyma, and also in detecting lymphadenopathy at or above the celiac axis, presacral extraperitoneal disease, and pelvic sidewall invasion [5,14,40,52,64-68]. Incomplete resection (residual tumor >1 cm) of primary tumor Staging and Follow-up of Ovarian Cancer yields little survival benefit while subjecting patients to substantial perioperative morbidity. To date, imaging and prediction models that are based on imaging, demographic characteristics, and tumor markers have not been shown to provide sufficiently high accuracy for prediction of suboptimal debulking to guide the decision regarding surgery [55,69]. Unresectable disease can be managed by needle or laparoscopic biopsy, followed by chemotherapy, and possibly by a later attempt at interval debulking, resulting in improved survival by virtue of response to chemotherapy and optimal resection [9,34,60-63]. Noncontrast-enhanced CT of the abdomen and pelvis offers limited ability to differentiate small peritoneal or mesenteric implants, or lymphadenopathy, from bowel or other adjacent organs. CT Chest CT of the chest is useful for detecting pleural and pulmonary metastases during primary staging.