Imaging is used as a noninvasive means to determine whether there is a mass lesion or other cause for a patient’s symptoms and physical examination findings.
In this context, the main purposes of imaging are to:
- Characterize whether the adnexal mass shows malignant features
- Determine whether the adnexal mass is resectable.
Collectively, imaging provides the clinician with a better understanding of tumor size, extension or involvement of other abdominal or pelvic organs, masses which press upon other organs, and involvement of distant sites such as: liver, spleen, lung, bone, or brain.
|Ultrasound (US)||Diagnostic evaluation tool
Combined with serum CA-125 for Risk of Malignancy Index (RMI) (>200 highly specific for malignancy)
Not used for clinical staging
|Transvaginal US (TVUS)||Distinguishing malignant from benign adnexal masses by architectural features:
|Transabdominal US (TAUS)||When mass is too large to evaluate by TVUS
Assesses pelvic, abdominal & retroperitoneal structures
|Computed Tomography (CT)||Diagnostic function, especially when ascites present
Monitoring recurrence & progression
|Magnetic Resonance Imaging (MRI)||Evaluation of indeterminate malignancy adnexal mass on US
Identification of pelvic organ invasion
Assessment of patients with increased serum CA-125 levels & negative abdominopelvic CT findings
|Positron Emission Tomography (PET)/CT||Ovarian cancer staging
Monitoring disease progression
Little use in characterizing complex adnexal tumors
Updated: June 8, 2018