Although FDG-PET/CT is an important oncologic imaging tool for cancer staging and detection of recurrence, it has no clear value for detecting ovarian cancer in asymptomatic individuals. In a Ovarian Cancer Screening systematic review of imaging modalities for preoperative evaluation of adnexal lesions, the sensitivity of PET was substantially lower than that of US or MRI [28], possibly because of the composition of ovarian neoplasms, many of which tend to be predominantly cystic with small solid components that may be below the size threshold for detection by PET. Variant 3: Ovarian cancer screening. Premenopausal. High risk (personal history or family history or known or suspected genetic predisposition or elevated CA-125). US Most studies discussed in this document have addressed the use of transvaginal US. In general, transabdominal US should be reserved for women in whom transvaginal US is not technically feasible, or used as a complement to transvaginal US. The University of Kentucky Ovarian Cancer Screening Study cohort [20] also included premenopausal women with a family history of ovarian cancer. The study results were reported in aggregate for patients with and without a family history of ovarian cancer. However, the authors note that there was no significant difference in the incidence of malignant or benign ovarian tumors between these groups. Although the results of this single-arm study were promising, a definitive mortality reduction has not been observed in randomized controlled trials [18,23]. MRI To our knowledge, there are no trials for the use of MRI as an ovarian cancer screening tool in high-risk women. MRI is unlikely to be investigated as a screening tool. CT To our knowledge, there are no trials of the use of CT as an ovarian cancer screening tool in high-risk women.
Ovarian Cancer Screening. Although FDG-PET/CT is an important oncologic imaging tool for cancer staging and detection of recurrence, it has no clear value for detecting ovarian cancer in asymptomatic individuals. In a Ovarian Cancer Screening systematic review of imaging modalities for preoperative evaluation of adnexal lesions, the sensitivity of PET was substantially lower than that of US or MRI [28], possibly because of the composition of ovarian neoplasms, many of which tend to be predominantly cystic with small solid components that may be below the size threshold for detection by PET. Variant 3: Ovarian cancer screening. Premenopausal. High risk (personal history or family history or known or suspected genetic predisposition or elevated CA-125). US Most studies discussed in this document have addressed the use of transvaginal US. In general, transabdominal US should be reserved for women in whom transvaginal US is not technically feasible, or used as a complement to transvaginal US. The University of Kentucky Ovarian Cancer Screening Study cohort [20] also included premenopausal women with a family history of ovarian cancer. The study results were reported in aggregate for patients with and without a family history of ovarian cancer. However, the authors note that there was no significant difference in the incidence of malignant or benign ovarian tumors between these groups. Although the results of this single-arm study were promising, a definitive mortality reduction has not been observed in randomized controlled trials [18,23]. MRI To our knowledge, there are no trials for the use of MRI as an ovarian cancer screening tool in high-risk women. MRI is unlikely to be investigated as a screening tool. CT To our knowledge, there are no trials of the use of CT as an ovarian cancer screening tool in high-risk women.