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This article discusses a study that aimed to evaluate the diagnostic accuracy of pelvic magnetic resonance imaging (MRI) in differentiating between benign and malignant adnexal masses. The study used the ADNEXMRSCORING system in cases where the IOTA Simple Rules (SR) were inconclusive. The results showed that pelvic MRI, combined with the ADNEXMRSCORING system, offers a promising second-line approach for diagnosing difficult adnexal masses. The findings suggest that this combined modality can improve diagnostic accuracy and guide appropriate management strategies for patients with these types of masses. [Extracted from the article]

Abstract: Background. : Metastatic bone involvement in vulvar squamous carcinoma is very rare. Here, we present a case of primary adenocarcinoma of the Bartholin''s gland giving rise to isolated skull metastasis. Case. : A 74-year-old woman was referred with a diagnosis of primary vulvar adenocarcinoma of the right labium minus. A right hemivulvectomy was performed with ipsilateral inguinofemoral lymphadenectomy, revealing a primary adenocarcinoma of the Bartholin''s gland and metastatic involvement in 6 out of 13 lymphnodes. During chemotherapy administration, the patient started complaining of a worsening of right hypoacousis. CT scan and MRI of the brain showed the presence of a metastatic lesion on the right side of the skullbone. The diagnosis was metastatic poorly differentiated adenocarcinoma. Conclusion. : In adenocarcinoma of the Bartholin''s gland at an advanced stage of disease, a bone scan or survey in the preoperative as well as follow up staging procedures could be useful. [Copyright &y& Elsevier]

On ultrasound assessment 95% of tumours (20/21) were unilateral, the largest tumour diameter was median 157 mm (IQR 107-181), and the largest solid component 110 mm (IQR 66-159). Hyperechoic stroma and elevated AFP can be useful to differentiate these tumours from other non-epithelial ovarian malignancies. [Extracted from the article]

This article presents the findings of a European multicentric observational cohort study that aimed to evaluate the performance of the peritoneal cancer index (PCI) using different imaging methods in assessing peritoneal carcinomatosis and predicting non-resectability in advanced tubo-ovarian cancer patients. The study compared the use of ultrasound, computed tomography (CT), and whole-body diffusion-weighted magnetic resonance imaging (WB-DWI/MRI) in calculating the PCI score. The results showed that ultrasound was non-inferior to CT in predicting non-resectability, and it was the best imaging method for determining preoperative PCI when performed by experienced examiners in dedicated oncological centers. [Extracted from the article]

An abstract of the article "Conservative management and ultrasonographic longitudinal follow-up of borderline ovarian tumor recurrences after fertility sparing surgery" by S. Mario and others, is presented.

This article presents a case report of a 35-year-old woman with bilateral enlarged ovaries. The patient had a history of polycystic ovary syndrome (PCOS) and had previously undergone surgeries for ovarian cysts. Despite the surgeries, her ovaries continued to enlarge due to her PCOS. The initial suspicion was spontaneous ovarian hyperstimulation syndrome (sOHSS), but further tests ruled out this diagnosis. The patient eventually underwent surgery to remove the cysts, and the histopathological examination confirmed the presence of serous cystadenofibromas. The article highlights the challenges in diagnosing bilateral cystadenofibromas and emphasizes the importance of thorough evaluation and clinical examination. [Extracted from the article]

This article discusses a case report of a rare tumor called struma ovarii (SO), which is characterized by the presence of thyroid tissue in the ovaries. Malignant transformation and metastasis of SO are rare, but when they occur, the most common subtypes are papillary and follicular thyroid carcinoma. The article presents the case of a 31-year-old patient with abdominal bloating, whose ultrasound examination revealed a solid mass in the right ovary. The patient underwent surgery, and the final histology report confirmed the presence of SO with foci of papillary thyroid carcinoma. The article emphasizes the importance of accurate preoperative diagnosis for appropriate treatment planning. [Extracted from the article]

This article discusses a case report of a rare malignant ovarian tumor called immature cystic teratoma. The tumor is composed of three germ cell layers and is characterized by the presence of immature tissue. The ultrasound features of this tumor are not well-defined, but in this particular case, the tumor appeared as a large, unilateral, cystic-solid formation with irregular margins and a heterogeneous echostructure. The patient underwent comprehensive surgical management and received adjuvant chemotherapy. Further studies are needed to better understand the ultrasound features of immature cystic teratomas. [Extracted from the article]

This article discusses a study that introduces a deep learning-based framework called ADNEX-AI for the automated detection of ovarian cancer using ultrasound scans. The study compares the performance of ADNEX-AI with traditional clinical practice in diagnosing ovarian cancer. The results show that ADNEX-AI achieves a high level of accuracy in distinguishing between benign and malignant ovarian tumors. However, the study suggests that the difference in performance between ADNEX-AI and traditional methods may be due to the clinician's ability to examine the tumor from different angles. Overall, ADNEX-AI demonstrates comparable performance to traditional methods when considering the constraints of tumor visibility. [Extracted from the article]

An abstract for article "Quantifying the risk of ovarian malignancy prior to surgery based on the IOTA simple rules" by B. Van Calster and others is presented.

EGISTs were typically large (median of 79 mm) and solid tumors (31/35, 89%), the remaining eGISTs were multilocular-solid tumors (4/35, 11%). Based on pattern recognition, eGISTs were usually correctly classified as malignant lesion (32/35, 91%) and the specific diagnosis of eGIST was the most frequent among the presumed diagnosis (16/35, 46%). They may mimic ovarian fibroma or uterine fibroids but the extra-genital origin in the combination with ultrasound characteristics in experienced hands point to the diagnosis of these uncommon tumours. [Extracted from the article]

There is a need for improved risk stratification in endometrial cancer to avoid unnecessary lymphadenectomies in cancers with low risk of lymph node metastasis (LNM). We used the IETA dataset (17 centres) of 1501 women with endometrial cancer undergoing expert ultrasound assessment prior to hysterectomy with or without lymphadenectomy. [Extracted from the article]

To describe the clinical and ultrasound features of ovarian mature cystic teratomas (MCTs). We included those patients with a histologically confirmed diagnosis of MCT that had been examined with ultrasound between 1999 and 2016 (IOTA phases 1, 2, 3 and 5) in five centres. All patients had undergone transvaginal ultrasound by an experienced ultrasound examiner who used the standardised IOTA examination technique and terminology. [Extracted from the article]

An abstract of the article "Imaging in gynecological disease: clinical and ultrasound features of immature teratomas of the ovary" by C. Landolfo and colleagues is presented.

To evaluate the concordance between histology obtained by ultrasound (US)-guided biopsy and surgery in patients with primary advanced ovarian cancer. In 6 cases, the histology obtained via US-guided biopsy was falsely negative, whereas in 4/102 cases, the biopsy obtained through surgery was negative (3 cases) or inadequate (1 case). OP07.13: Prospective study evaluating the role of ultrasound-guided biopsy as a useful tool in patients with suspected advanced ovarian cancer. [Extracted from the article]

Results The tool provides four output modules: (i) binary malignancy prediction (Morphonode-RFC), (ii) risk signature (Morphonode-DT), (iii) point malignancy risk estimation (Morphonode-RBM), (iv) selection of the top-5 similar profiles in the study series (Morphonode-SP). To build a robust, multi-modular model based on artificial intelligence, able to preoperatively assess inguinal lymph nodes in patients with vulvar carcinoma using ultrasound. Morphonode-DT identifies 4 specific signatures correlated with the risk of metastases: metastatic signature (MET), high metastatic risk (HMR), moderate metastatic risk (MMR) and low metastatic risk (LMR). [Extracted from the article]

CT and WB-DWI/MRI had similar results regarding AUC and sensitivity (0.79 versus 0.78 and 88.6% versus 87.5%), with lower specificity for CT (68.8% versus 86%). The aim of the European multicentric prospective study (ISAAC study, Imaging Study on Advanced ovArian cancer) was to test the non-inferiority of abdominopelvic ultrasound compared to computed tomography (CT) and whole-body diffusion-weighted magnetic resonance imaging (WB-DWI/MRI) in prediction of surgical outcome in patients with ovarian/tubal/peritoneal cancer. Methods All consecutive patients, with suspected ovarian cancer planned for surgery underwent preoperative prediction of non-resectability with ultrasound, CT and WB-DWI/MRI at 5 European centres. [Extracted from the article]

To describe ultrasound features of fetal ovarian cysts as reported by the original ultrasound examiner and according to IOTA terminology. Ovarian cysts with low level content could be managed expectantly, whereas ovarian cysts with other cyst content should be managed with postnatal surgery, due to the high risk of necrosis at final histology. [Extracted from the article]

To evaluate the stratification of patients with an adnexal mass into ovarian-adnexal reporting and data system (O-RADS) risk intervals based on ACR features and the IOTA two-step strategy. The IOTA two-step strategy classified 40% of all patients into O-RADS2 (0.9% prevalence of malignancy), 27% into O-RADS3 (4.4%), 14% into O-RADS4 (29.8%), and 19% into O-RADS5 (82%). The adnexal lesions underwent risk stratification into O-RADS categories using ACR features or the IOTA two-step strategy. [Extracted from the article]

Therefore, an ultrasound guided biopsy on the omentum was performed and the histology was positive for an ovarian Müllerian carcinoma. After two cycles of carboplatin/paclitaxel-based chemotherapy, the serum value of CA125 was 80 U/mL and the ultrasound examination at 32 weeks showed a progression of abdominal peritoneal disease. [Extracted from the article]

An abstract of the article "Ultrasound characteristics of serous borderline ovarian tumors, non-invasive low-grade, invasive low-grade and high-grade serous carcinomas" by B. Cinzia and others is presented.

An abstract for the article "Assessment of the vascular tree marginally improves discrimination of ovarian tumors difficult to classify as benign or malignant on 2D ultrasound" by P. Sladkevicius and others is presented.

Metastases of breast cancer commonly involve ovaries, while the myometrium is rarely affected. We described the case of an asymptomatic 52-year-old woman who developed uterine and ovarian metastases two years after the diagnosis of an invasive ductal breast carcinoma with lymph node involvement and positive hormonal receptors. Uterine metastases from breast cancer are uncommon and rarely reported in the literature. [Extracted from the article]

The ultrasound examiner was uncertain to the diagnosis: the first hypothesis was a metastatic tumour due to the personal history, bilateral tumours and negative CA 125. Malignant mesothelioma is an uncommon tumour that can be difficult to diagnose and there are no studies describing the ultrasound feature of ovarian malignant mesothelioma. [Extracted from the article]

Results For discriminating high risk category vs the other categories one random forest model from the radiomics features (radiomics model), and two logistic regression models from clinical and ultrasound features (clinical-ultrasound model), and from clinical, ultrasound and radiomics features (mixed model) were created. Aim of this study was to develop and validate ultrasound-based radiomics models, aiming to differentiating high risk category, as defined by ESMO-ESGO-ESTRO in 2016, vs the remaining categories of risk. OC10.01: *Developing and validating ultrasound-based radiomics models for predicting high-risk category in endometrial cancer patients. [Extracted from the article]

A laparoscopy-based scoring model to assess the resectability in ovarian cancer was developed by Fagotti. Agreement between ultrasound and laparoscopy was almost perfect for great omentum ( =0.85), substantial for liver surface ( =0.73), diaphragms ( =0.70), parietal peritoneum ( =0.63) and bowel ( =0.77); moderate for lesser omentum/stomach/spleen ( =0.54). Patients with clinical or radiological suspicion of ovarian/peritoneal cancer between January 2019 and June 2020 were assessed with preoperative ultrasound examination and assigned a score based on the six Fagotti's score parameters (great omentum, liver surface, lesser omentum/stomach/spleen, parietal peritoneum, diaphragms, bowel). [Extracted from the article]

This is a prospective study to describe the prevalence and morphological features of benign endometrial polyps in women without abnormal uterine bleeding. Patients presenting in 15 ultrasound centres from 2011 until 2018 for indications unrelated to abnormal bleeding, underwent an ultrasound examination followed by endometrial sampling. Endometrial polyps are common in women without abnormal bleeding undergoing an ultrasound scan for reasons unrelated with bleeding problems. [Extracted from the article]

In this retrospective study, subjects prospectively collected between 1997 and 2015 in the International Ovarian Tumour Analysis (IOTA) studies were searched for the histological confirmation of a mature cystic teratoma. Data were extracted from the databases of five ultrasound centre for IOTA phases 1-3 and phase 5, in which ultrasound examination was performed according to a standardised research protocol. Median lesion diameter was 66.5 mm [range: 15-310 mm]. [Extracted from the article]

To estimate and validate cut-offs for objective measurements to predict deep myometrial invasion (MI), cervical stromal invasion (CSI). In this series, the optimal cut-off for MI for tumour/uterine AP ratio was 0.52 (accuracy 71%, AUC 0.77), for CSI for Dist-OCO was 23mm (accuracy 70%, AUC 0.77). Tumour/uterine AP ratio at the 0.52-0.53 cut-off and dist-OCO of 21-23mm had an accuracy of 70-74% and 65-70% to predict MI and CSI, respectively. [Extracted from the article]

EP34.20: Diagnostic algorithm for uterine sarcoma identification: a one-year interim analysis of a monocentric prospective, observational cohort study In this 1-year interim analysis, we analysed 816 patients who were selected by MYLUNAR study criteria. By defining an accurate diagnostic algorithm in identifying patients with uterine sarcomas, MYLUNAR study may represent the guideline in the management of women with myometrial lesion. [Extracted from the article]

This is a retrospective study comprising patients who had undergone transvaginal ultrasound-guided biopsy for either primary suboptimally operable tumours (evaluated by ultrasound and TC or MRI), recurrence, or suspected genital, non-genital or secondary tumour, between April 2015 to May 2018. Transvaginal biopsies were obtained with an 18-G/25 cm core-cut biopsy needle. The site of transvaginal ultrasound biopsy was vaginal cuff in 25/63 (40%) patients, cervix in 16/63 (25.3%), vaginal wall in 12/63 (19%), pelvic region in 7/63 (11.1%) and periuretral region in 3%63 (4.8%). [Extracted from the article]

Patients underwent MRI followed by conventional TVUS examination and fusion imaging technique (Toshiba Aplio i800) before and after neoadjuvant treatment. Fusion imaging allowed superimposing MRI and US images therefore providing with real time imaging capabilities. Fusion imaging could be used as a complementary technique to MRI and TVUS to enhance the diagnostic performance of cervical cancer. [Extracted from the article]

To evaluate the feasibility of Fusion of SPECT/CT and ultrasound in detecting sentinel lymph nodes in patients with vulvar cancer. The present study demonstrated that the fusion virtual navigation using SPECT/CT and ultrasound is feasible and it is able to detect sentinel lymph nodes in patients with vulvar carcinoma. [Extracted from the article]

From the databases of eight ultrasound centres, we identified patients with a surgically confirmed diagnosis of adnexal torsion, who had undergone preoperative ultrasound examination between 2012 and 2018. "Ovarian edema with or without peripherally displaced follicles" was reported in 167/241 (69.3%) patients, "whirlpool sign" in 178/226 (78.4%), and "follicular ring sign" in 51/134 (38.1%). On retrospective review of images, "ovarian edema with or without peripherally displaced follicles" sign (201/254; 79.1%) and "whirlpool sign" (139/153; 90.8%) were the most commonly detected features of adnexal torsion. [Extracted from the article]

Intraoperative ultrasound (IOUS) is an imaging technique already used in different surgical scenarios, nevertheless only few case series have been published on the role of IOUS in gynecologic surgery. The most frequent indication for surgery was suspicion of gynecological tumour recurrence (54.1%), and the most frequent surgical approach during IOUS procedure was endoscopic (standard LPS + robot assisted surgery, 56.9%). Most frequent indication for IOUS was to identify the lesion not detectable during surgery, but reported on preoperative imaging (45.8%), followed by exclusion of the presence of residual lesion (33.3%). [Extracted from the article]

Patients presenting in 15 ultrasound centres from 2011 until 2018 for indications unrelated to abnormal bleeding, underwent an ultrasound examination followed by endometrial sampling on indication. The premenopausal malignancy was an endometrioid adenocarcinoma grade 1, FIGO stage IA. [Extracted from the article]

To describe clinical and ultrasound features of malignant ovarian masses in pregnant women. 2/22 (9%) patients had a mucinous borderline tumour, 8/22 (36.4%) had a serous or endocervical-type borderline tumour, 7/22 (31.8%) had a primary epithelial ovarian carcinoma and 5/22 (22.8%) had a metastatic tumour to the ovary. On ultrasound, mucinous ovarian borderline tumours were described as multilocular (1/2,50%) or multilocular-solid (1/2,50%) lesions, with a minimal vascularisation. [Extracted from the article]

OP03.08: Role of CA125/CEA ratio and ultrasound parameters in identifying metastases to the ovaries in patients with multilocular and multilocular-solid ovarian masses To investigate ultrasound features and the best cut-off value of CA125/CEA ratio to discriminate primary ovarian carcinomas from metastatic tumours in selected groups of morphological ovarian masses: multilocular masses more than 5 locules and multilocular-solid lesions. ROC curve analysis showed that the best cut-off value of CA125/CEA ratio was 19.7 for discriminating primary ovarian carcinomas versus ovarian metastases, and the predictive performance of CA125/CEA >19.7 for primary ovarian carcinomas was: AUC of 0.856 (95%CI 0.800 - 0.913), sensitivity 87.3% and specificity 67.4%. [Extracted from the article]