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Objectives: To compare the performance of transvaginal and transabdominal ultrasound with that of the first-line staging method (contrast-enhanced computed tomography (CT)) and a novel technique, whole-body magnetic resonance imaging with diffusion-weighted sequence (WB-DWI/MRI), in the assessment of peritoneal involvement (carcinomatosis), lymph-node staging and prediction of non-resectability in patients with suspected ovarian cancer.Methods: Between March 2016 and October 2017, all consecutive patients with suspicion of ovarian cancer and surgery planned at a gynecological oncology center underwent preoperative staging and prediction of non-resectability with ultrasound, CT and WB-DWI/MRI. The evaluation followed a single, predefined protocol, assessing peritoneal spread at 19 sites and lymph-node metastasis at eight sites. The prediction of non-resectability was based on abdominal markers. Findings were compared to the reference standard (surgical findings and outcome and histopathological evaluation).Results: Sixty-seven patients with confirmed ovarian cancer were analyzed. Among them, 51 (76%) had advanced-stage and 16 (24%) had early-stage ovarian cancer. Diagnostic laparoscopy only was performed in 16% (11/67) of the cases and laparotomy in 84% (56/67), with no residual disease at the end of surgery in 68% (38/56), residual disease ≤ 1 cm in 16% (9/56) and residual disease > 1 cm in 16% (9/56). Ultrasound and WB-DWI/MRI performed better than did CT in the assessment of overall peritoneal carcinomatosis (area under the receiver-operating-characteristics curve (AUC), 0.87, 0.86 and 0.77, respectively). Ultrasound was not inferior to CT (P = 0.002). For assessment of retroperitoneal lymph-node staging (AUC, 0.72-0.76) and prediction of non-resectability in the abdomen (AUC, 0.74-0.80), all three methods performed similarly. In general, ultrasound had higher or identical specificity to WB-DWI/MRI and CT at each of the 19 peritoneal sites evaluated, but lower or equal sensitivity in the abdomen. Compared with WB-DWI/MRI and CT, transvaginal ultrasound had higher accuracy (94% vs 91% and 85%, respectively) and sensitivity (94% vs 91% and 89%, respectively) in the detection of carcinomatosis in the pelvis. Better accuracy and sensitivity of ultrasound (93% and 100%) than WB-DWI/MRI (83% and 75%) and CT (84% and 88%) in the evaluation of deep rectosigmoid wall infiltration, in particular, supports the potential role of ultrasound in planning rectosigmoid resection. In contrast, for the bowel serosal and mesenterial assessment, abdominal ultrasound had the lowest accuracy (70%, 78% and 79%, respectively) and sensitivity (42%, 65% and 65%, respectively).Conclusions: This is the first prospective study to document that, in experienced hands, ultrasound may be an alternative to WB-DWI/MRI and CT in ovarian cancer staging, including peritoneal and lymph-node evaluation and prediction of non-resectability based on abdominal markers of non-resectability. © 2021 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Objective: To examine prospectively the accuracy of ultrasound in predicting rectosigmoid tumor infiltration in patients with epithelial ovarian cancer.Methods: Patients referred for a suspicious pelvic mass between 2012 and 2014 were examined by ultrasound following the standard protocol for assessment of tumor infiltration. Of the 245 patients examined, 191 had proven ovarian cancer and underwent primary surgery and were included in the analysis. Patients with apparently benign or inoperable disease were excluded. Rectosigmoid infiltration was evaluated by histopathology or according to perioperative findings. Clinical, pathological and laboratory parameters were analyzed as factors potentially affecting the sensitivity and specificity of sonography.Results: The sensitivity of ultrasound in detecting rectosigmoid infiltration in patients with ovarian cancer was 86.3%, with specificity of 95.8%, positive predictive value of 92.6%, negative predictive value of 91.9% and overall accuracy of 92.1%.Conclusion: Ultrasound is a highly accurate method for detecting rectosigmoid tumor infiltration in ovarian cancer patients, and thus, can be used for planning adequate management, including patient consultation, surgical team planning, suitable operating time and postoperative care. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

Objective: To analyze the accuracy of ultrasound in assessing pelvic and intra-abdominal spread in patients with ovarian cancer.Methods: This prospective study enrolled all consecutive patients referred to a single gynecological oncology center for suspected ovarian cancer. We analyzed only data from patients with histologically confirmed primary ovarian cancer who were evaluated following predefined preoperative ultrasound, intraoperative and pathology protocols. We evaluated the agreement of depth of infiltration of the rectosigmoid wall, tumor spread in different peritoneal compartments and presence of metastatic retroperitoneal and inguinal lymph nodes, as determined at ultrasound, with intraoperative and histopathological findings.Results: In total, 578 patients were enrolled between March 2008 and January 2013, of whom 394 met the study inclusion criteria and were analyzed; 74% of these suffered from advanced-stage cancer. Our results showed excellent agreement between ultrasound and histology in assessment of rectosigmoid wall infiltration (kappa value, 0.812; area under the receiver-operating characteristics curve, 0.898). The overall accuracy in evaluating different peritoneal compartments, retroperitoneal and inguinal lymph nodes and depth of rectosigmoid wall infiltration was 85.3%, 84.8%, 99.7% and 91.1%, respectively. Ultrasound showed high sensitivity only in the assessment of rectosigmoid wall infiltration (83.1%), peritoneal spread into the pelvis (81.4%) and omentum (67.3%), and inguinal metastatic lymph nodes (100%). The specificity of ultrasound in detection of all evaluated parameters was > 90%.Conclusion: This is the largest imaging study to date on ovarian cancer staging. Ultrasound can be used as the method of choice to plan rectosigmoid wall resection and dissection of infiltrated inguinal lymph nodes. In assessing different peritoneal and retroperitoneal compartments, ultrasound was accurate and highly specific. However, similar to other modern imaging techniques, it had relatively low sensitivity, further supporting the role of comprehensive surgical staging. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

An abstract of the article "Ultrasound accuracy in prediction of pelvic carcinomatosis and rectosigmoid involvement in advanced ovarian cancer patients." by M. Zikan and others is presented.

The aim of the study was to evaluate diagnostic accuracy of ultrasound (US) in preoperative assessment of lymph nodes (LNs) in cervical cancer patients, to compare the outcomes for pelvic and paraaortic region and for macro- and micromets separately. Methods Patients were retrospectively included if they met inclusion criteria: histologically verified cervical cancer; preoperative US; surgical LN staging - sentinel node biopsy or systematic lymphadenectomy or LN debulking. [Extracted from the article]

ABSTRACT Objectives To identify major factors in the under- and overestimation of cervical and myometrial invasion by endometrial cancer at preoperative staging by ultrasound. Methods This prospective study involved all patients with histologically confirmed endometrial cancer referred consecutively for surgical staging between January 2009 and December 2011. All patients underwent transvaginal ultrasound examination, obtaining metric and perfusion data, and the results were compared with final histology: myometrial invasion was defined at histology in the final pathology report as being either < or ≥ 50%, while cervical stromal invasion was reported as being either present or absent, and sonographic over-/underestimation was determined relative to these. Results Enrolled prospectively into the study were 210 patients. The proportion of cases with sonographic underestimation, relative to final histology, of myometrial invasion (i.e. false-negative estimation of no or superficial invasion < 50%) and of cervical invasion (i.e. false-negative finding of absence of stromal invasion) was comparable: 8.6% ( n = 18) and 10.5% ( n = 22), respectively. Myometrial invasion was overestimated by ultrasound (i.e. false-positive estimation of deep invasion ≥ 50%) in 15.7% ( n = 33) of cases, and cervical invasion was overestimated (i.e. false-positive finding of presence of stromal invasion) in 4.8% ( n = 10) of cases. These outcomes correspond to positive and negative predictive values of 67.6% (95% CI, 57.7-76.6) and 83.3% (95% CI, 74.9-89.8), respectively, for the subjective assessment of myometrial invasion, and 60.0% (95% CI, 38.2-79.2) and 88.1% (95% CI, 82.5-92.4), respectively, for that of cervical stromal invasion. The staging error in subjective assessment was not related to body mass index ( BMI), to the position of the uterus in the pelvis or to image quality. Cervical and myometrial invasion were more often underestimated in well-differentiated endometrial cancers that were smaller in size, with thick minimum tumor-free myometrium and lower perfusion, and more often overestimated in moderately and poorly differentiated cancers that were larger in size, with thin minimum tumor-free myometrium and richer perfusion. Conclusion The accuracy of subjective assessment of myometrial and cervical invasion by ultrasound was significantly influenced by tumor size, density of tumor vascularization, tumor vessel architecture and histological grading, while it was not significantly affected by BMI, uterine position and image quality. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives To assess the accuracy of magnetic resonance imaging ( MRI) and transrectal ultrasound ( TRUS) in the evaluation of tumor size and in the detection of residual tumor following neoadjuvant chemotherapy ( NACT) in patients with cervical cancer. Methods This was a prospective study involving 42 women with locally advanced histologically confirmed cervical cancer referred for NACT. Clinical examination, TRUS and MRI were performed before and after NACT. The tumor volume was calculated using three standardized diameters (anteroposterior, laterolateral and craniocaudal) that were measured using both TRUS and MRI. Thereafter patients underwent surgical treatment and the same tumor measurements were taken by a pathologist using a fixed surgical specimen. Tumor volumes were calculated from tumor dimensions using the ellipsoid formula, and data obtained from both imaging methods were compared with pathological results as the gold standard. Results Twelve cases were excluded from the study owing to disease progression (these patients were referred for primary radiotherapy) or inability to perform MRI, leaving data from 30 patients for the final analysis. On average, tumor volume decreased after NACT by 84.6 and 87.1% as measured by MRI and TRUS, respectively. The agreement between measurements obtained by MRI and histology did not reach significance (intraclass correlation coefficient, 0.344 (95% CI, -0.013 to 0.610), P = 0.059), while agreement between TRUS and histology was statistically significant (intraclass correlation coefficient, 0.795 (95% CI, 0.569-0.902), P < 0.001). The accuracy of residual tumor detection (for non-microscopic tumors > 5 mm3 in volume) reached 77% for both MRI and TRUS. The sensitivity of TRUS was, however, lower than that of MRI (83 vs 96%). The positive predictive values were similar for the two methods. Conclusions TRUS should be considered as an accurate diagnostic method in the evaluation of tumor volume after NACT in patients with cervical cancer and may constitute a reliable alternative imaging method to MRI. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

J. Slama, P. Freitag, P. Dundr, J. Duskova, D. Fischerova, M. Zikan, I. Pinkavova and D. Cibula Outcomes of pregnant patients with Pap smears classified as atypical glandular cells Objectives: The incidence of cervical cancers increases with age. Due to the trend of increasing age of first pregnancy, abnormal Pap smears including those classified as atypical glandular cells (AGC) are being found more often in early pregnancy. Once invasive cancer is excluded, conservative management of squamous intraepithelial lesions (SIL) in pregnancy is considered safe; however, optimal management of AGC is not well established. The aim of our study was to evaluate the outcome of patients with AGC diagnosed from smears during pregnancy. Methods: The study included 17 patients referred to us in early pregnancy with Pap smears reported as AGC: 11 not otherwise specified (AGC-NOS), five favour neoplasia (AGC-FN) and one adenocarcinoma in situ (AIS). Thirty-one with high-grade SIL (HSIL) Pap smears confirmed on punch biopsy in early pregnancy comprised a control group. Human papillomavirus (HPV) positivity was found in seven patients with persistent AGC-NOS (including all four who had CIN3 postpartum). All the women were initially examined by expert colposcopy and those with AGC-FN or AIS smears also by transrectal ultrasound to exclude invasive endocervical cancer. Follow-up controls were carried out every 8-12 weeks and, if there were no signs of progression, revaluation was scheduled 6-8 weeks after delivery. Results: The mean age of the women was 31.4 years. Conization in one patient in the study group was performed in the 16th week of pregnancy due to colposcopic signs of microinvasive squamous cell cancer confirmed on histology. Progression to invasive cancer was not found in any of the other 16 patients in the study group or in the control group. Cervical intraepithelial neoplasia or AIS was confirmed postpartum by conization or punch biopsy in 47.1% (8/17) of patients in the study group and, in 77.4% (24/31) of patients in the control group. Conclusions: Conservative management of women with AGC in pregnancy is safe where invasive cancer is excluded. As histological verification of glandular pre-cancerous lesions by punch biopsy is not reliable and the postpartum regression rate cannot be determined precisely, conization should be performed in all cases with AGC-FN or AIS. Triage of persistent AGC-NOS with HPV testing is useful in distinguishing significant underlying lesions. [ABSTRACT FROM AUTHOR]

Objective To describe the ultrasound (sonomorphologic and vascular) characteristics of metastatic non-gynecological pelvic tumors, and to identify ultrasound characteristics typical of the most common non-gynecological pelvic tumors. Methods In 92 patients with a pelvic mass who had undergone ultrasound examination with subsequent surgery or tru-cut biopsy revealing a metastatic non-gynecological tumor origin, we analyzed retrospectively the sonomorphologic and vascular parameters. All parameters were evaluated for the whole group of non-gynecological tumors as well as separately for each specific tumor type. The findings were compared with those from 100 women with epithelial ovarian cancer. Results We found that CA 125, size of tumor, echogenicity, homogeneity of solid portion, mobility, and presence of ovarian crescent sign, parenchymal metastases and suspicious necrosis were individual statistically significant discriminators ( P < 0.01) between the metastatic non-gynecological tumor group and the epithelial ovarian cancer group. Conclusions Metastatic non-gynecological tumors in the pelvis have a significantly different sonomorphologic pattern compared with primary epithelial ovarian cancer. This pattern is dependent on the primary origin of the tumor. Doppler parameters, however, cannot differentiate between primary ovarian cancer and metastatic non-gynecological tumors. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The article focuses on the study that analyzed the safety, adequacy and accuracy of tru-cut biopsy of abdominal and pelvic tumors. The study analyzed a group of patients who undergo tru-cut biopsy using automatic biopsy gun, either transvaginally or transabdominally. A conclusion is stated that ultrasonic-guided tru-cut biopsy is an effective and safe method of diagnosing pelvic and abdominal tumors of where the laparoscopy or laparotomy can be avoided.

To evaluate diagnostic performance of ultrasound, CT and WB-DWI/MRI (whole-body MRI with diffusion-weighted sequence) in preoperative work-up and assessment of optimal operability in patients with ovarian cancer. They underwent preoperative staging with ultrasound, CT, and WB-DWI/MRI, using the same evaluation form. This is the first prospective study to date documenting the potential role of ultrasound in ovarian cancer staging compared to the method of choice (CT) and a novel imaging method (WB-DWI/MRI). [Extracted from the article]

An abstract of the article "Ultrasound accuracy in prediction of rectosigmoid involvement in advanced ovarian cancer patients," by M. Zikan, D. Fischerova, I. Pinkavova, and D. Cibulas is presented.

An abstract of the article "Ultrasound in preoperative assessment of pelvis and abdominal spread in patients with ovarian cancer: a prospective study" by D. Fischerová and colleagues is presented.

An abstract of the article "Efficient mini-invasive treatment of symptomatic lymphocele with ultrasound-guided drainage," by M. Zikan and colleagues is presented.

An abstract of the article "Can 4D STIC bi-directional power Doppler tissue evaluation help discriminate between normal ovaries and ovarian cancer tumours?," by M. J. Kudla and colleagues is presented.

An abstract of the article "The role of ultrasound in lymph node staging in vulvar cancer" by P. Pinto and colleagues is presented.

An abstract of the conference paper "Ultrasound diagnosis of extragenital abdominopelvic tumors," by D. Fischerova and colleagues is presented.

An abstract of the conference paper "Adequacy and safety of ultrasound guided tru-cut biopsy in the management of abdomino-pelvic tumors" by M. Zikan and colleagues is presented.

An abstract of the article "*Agreement of 2D and 3D ultrasound and magnetic resonance imaging in the assessment of rectosigmoid infiltration in primary or recurrent ovarian cancer" by V. Chiappa and colleagues is presented.

An abstract of the article "The association of changes in cervical cancerechogenicity and vascularization with treatment effect of neoadjuvant chemotherapy" by F. Frühauf and colleagues is presented.

An abstract of the article "Factors affecting sonographic preoperative local staging of endometrial cancer" by D. Fischerová and others, is presented.

An abstract of the article "The diagnostic accuracy of ultrasound in assessment of myometrial and cervical invasion in endometrial cancer: subjective assessment vs. objective techniques" by L. Dusek and others, is presented.

An abstract of the research paper "Prevalence of lymphocysts after pelvic and paraaortic lymphadenectomy and treatment with mini invasive ultrasound-guided drainage," by M. Zikan and colleagues is presented.

An abstract of the research paper "Ultrasound accuracy in prediction of pelvic carcinomatosis in advanced ovarian cancer patients," by M. Zikan and colleagues is presented.

An abstract of the article "The role of ultrasound in planning fertility sparing surgery and individual treatment in early stage cervical cancer," by D. Fischerova, M. Zikan, I. Pinkavova, F. Frühauf, P. Dundr, K. Nemejcova, A. Burgetova, and D. Cibula is presented.

An abstract of the article "Permanent peritoneal catheter introduced under ultrasound guidance as a palliative derivation of torpid ascites," by M. Zikan, I. Pinkavova, D. Fischerova and D. Cibula is presented.

An abstract of the article "Early stage cervical cancer: tumor delineation by magnetic resonance imaging and ultrasound in a preoperative staging, verified by pathological results: the results of an European multicentre trial," by E. Epstein, A. Testa, and A. Gaurilcikas is presented.

An abstract of the article "Intra-operative ultrasound in fertility sparing procedures for cervical cancer," by D. Fischerova, M. Zikan, I. Pinkavova, F. Frühauf, P. Dundr, K. Nemejcova, A. Burgetova, and D. Cibula is presented.

An abstract of the article "Morphological and vascular ultrasound characteristics of pelvic masses of non-gynecological origin," by M. Zikan and colleagues is presented.

An abstract of the conference paper "Ultrasound characteristics of non-genital abdomino-pelvic tumors," by M. Zikan and colleagues is presented.

An abstract of the conference paper "Analysis of factors influencing tru-cut biopsy sample adequacy in management of abdomino-pelvic masses," by M. Zikan and colleagues is presented.

An abstract of the conference paper "Role of ultrasound in the referral of young patients with cervical cancer for fertility sparing surgery," by D. Fischerova and colleagues is presented.

An abstract of the conference paper "Transrectal ultrasound in the evaluation of locally advanced cervical cancer after neoadjuvant chemotherapy," by I. Pinkavova and colleagues is presented.

An abstract of the conference paper "The role of ultrasound in prediction of optimal vs. suboptimal cytoreductive surgery in advanced ovarian cancers," by D. Fischerova and colleagues is presented.