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Discrepancy Between Preoperative Imaging and Surgical Findings in Patients With Advanced Ovarian Cancer: A Study of Initial False-Negative Lesions

Ko, Seok Min MD; Jung, Dae Chul MD; Oh, Young Taik MD; Kim, Sun Ho MD; Kang, Sokbom MD

Journal of Computer Assisted Tomography: July/August 2013 - Volume 37 - Issue 4 - p 568–571
doi: 10.1097/RCT.0b013e31828b683b
Abdominal Imaging

Objective The objective of this study was to determine the patterns of erroneous interpretation of preoperative computed tomography (CT) for detection of peritoneal lesions in advanced ovarian cancer.

Methods Between 2007 and 2011, 148 patients with International Federation of Gynecology and Obstetrics stage IIIC-IV ovarian cancer, who underwent multi–detector-row CT before primary cytoreduction, were enrolled. We reviewed the preoperative CT and compared the findings with the surgical findings. For the discrepant cases, false-negative cases were reevaluated after revealing of surgical findings and were categorized as either absence or presence of lesion (missed case). We performed region-based comparisons according to predefined peritoneal lesion locations.

Results Sixty-eight false-negative cases were identified, of which 43 were revealed to be initially missed cases. The most common locations were found to be the small-bowel mesentery (21%), subdiaphragmatic space (19%), and porta hepatis (16%).

Conclusions The missed peritoneal implants commonly resided in the same sites of preoperative imaging criteria that could predict suboptimal primary cytoreduction.

From the *Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul; and †Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea.

Received for publication November 15, 2012; accepted February 4, 2013.

Reprints: Dae Chul Jung, MD, Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea (e-mail: daechul@yuhs.ac).

This study was financially supported by the “Dongwha Holdings” Faculty Research Assistance Program of Yonsei University College of Medicine for 2012 (6-2012-0098).

None of the authors have identified a conflict of interest.

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.