How U/S quality affects ovarian Ca management

In patients with suspected ovarian cancer, the use of expert gynecologic ultrasonographers, compared with nonspecialists, improves diagnostic accuracy and reduces the number of major surgical staging procedures required to confirm or rule out a diagnosis of cancer, reports an article published online Jan. 21 in The Lancet.

British researchers randomly assigned 150 patients with suspected adnexal tumors to level II (routine) ultrasonography or level III (expert) ultrasonography and then compared the number of surgical procedures performed in each group.

More major surgical staging procedures were performed in the level II group-27 of 73 (37%) than in the level III group-17 of 77 (22%)-although the total number of surgical procedures was similar between groups. Ultrasound results provided clinicians with a likely histological diagnosis in 76 of 77 (99%) of the level III patients but in only 38 of 73 (52%) of the level II group.

"This finding is likely to be the consequence of the greatly increased proportion of patients in whom a conclusive diagnosis of the nature of the adnexal tumour was possible from level III ultrasonography compared with level II ultrasonography," conclude the authors.

Yazbek J, Raju SK, Ben-Nagi J, et al. Effect of quality of gynaecological ultrasonography on management of patients with suspected ovarian cancer: a randomised controlled trial. Lancet Oncol. 2008;9:124-131. doi:10.1016/S1470-2045(08)70005-6.