Abstract
Background
In order to obtain timely treatment, the early detection of recurrent ovarian cancer is essential. Despite technical advances in multi-detector row computed tomography (MDCT), low sensitivity of CT for recurrence has not been improved much due to its poor soft tissue discrimination.
Purpose
The aim of this study is to describe patterns of erroneous postoperative MDCT interpretation of recurred peritoneal lesions in patients with advanced ovarian cancer (AOC).
Material and methods
Between 2011 and 2018, we reviewed postoperative follow-up positron emission tomography (PET)/CT images of 240 patients with suspected recurrence based on the images and history of initially diagnosed AOC (International Federation of Gynecology and Obstetrics stage IIIC–IV) who had undergone primary cytoreduction. With awareness of recurred location, we re-evaluated MDCT images taken right before the recurrence was detected on PET/CT and categorized these cases as either the absence of a lesion or the presence of a lesion (missed case). We performed region-based comparisons of these missed cases according to predefined peritoneal locations.
Results
Re-evaluation of follow-up MDCT images revealed that 46.9% (105/224) of recurrent lesions were missed. Through region-based analysis, the most commonly missed site was the pelvic cavity (19.0%, 20/105), followed by the porta hepatis (15.2%, 16/105) and the para-aortic/aortocaval lymphadenopathy (13.3%, 14/105).
Conclusion
Radiologists should be concerned about these frequently overlooked regions in postoperative follow-up MDCT images when potential risks are identified. Familiarity with these imaging features may aid in the detection of recurrence and facilitate appropriate management.
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