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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.

© 2013 by Lippincott Williams & Wilkins