Imaging of Ovarian Cancer: From Early Detection to Post-treatment Relapse

Abstract

Ovarian cancer refers to a multitude of different cancer types originating from or involving the ovaries. Although it ranks third in gynaecological cancers, it is among the deadliest cancers in females. The prognosis mainly depends on early detection, but the majority of cases are diagnosed at advanced stages. Exact tumour delineation is crucial for individualised therapy planning. This review provides a practical update of the role of imaging in every phase throughout the course of this disease. The imaging technique of choice depends mainly on the clinical setting. Sonography remains the first-line imaging modality for cancer detection and is the most important for characterisation of adnexal masses. MRI is a valuable complementary imaging tool in sonographically indeterminate findings. For ovarian cancer staging, CT is considered an optimal imaging technique. CT renders all critical information for treatment stratification. It assists in surgery planning by displaying the load and the distribution of the disease and alerts to sites difficult to resect. It also renders critical information in selecting patients more suitable for medical therapy. In females treated for ovarian cancer, imaging is only recommended when there is suspicion of recurrence, where CT and PET/CT are most commonly used to confirm relapse and provide pivotal information for individualised treatment.