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Imaging before cytoreductive surgery in advanced ovarian cancer patients
  1. Stefania Rizzo1,
  2. Maria Del Grande2,
  3. Lucia Manganaro3,
  4. Andrea Papadia4,5 and
  5. Filippo Del Grande1
  1. 1 Istituto Imaging Svizzera Italiana, Ente Ospedaliero Cantonale, Lugano, TI, Switzerland
  2. 2 Oncology Institute of Southern Switzerland, Bellinzona, TI, Switzerland
  3. 3 Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Roma, Lazio, Italy
  4. 4 Department of Gynecology, Ente Ospedaliero Cantonale, Lugano, TI, Switzerland
  5. 5 Facoltà di Scienze Biomediche, Università della Svizzera Italiana, Lugano, TI, Switzerland
  1. Correspondence to Dr Stefania Rizzo, Istituto Imaging Svizzera Italiana, Ente Ospedaliero Cantonale, Lugano 6900, Switzerland; stefania.rizzo{at}eoc.ch

Abstract

Appropriate and accurate pre-operative imaging in epithelial ovarian cancer patients may allow selection of patients that may mostly benefit either from primary cytoreductive surgery or from neoadjuvant chemotherapy. If the patient is considered suitable for upfront surgery, pre-operative imaging may help in planning the surgical approach, to forecast the operating time, and to estimate the need for other consulting specialists. Currently, computed tomography (CT) imaging is the standard of care for pre-operative evaluation of ovarian cancer patients; however, advanced magnetic resonance imaging (MRI) is emerging as a technique that may overcome the limitations of CT imaging, especially for small peritoneal deposits in difficult-to-resect sites. Positron emission tomography (PET)-CT imaging in the pre-operative setting is currently limited, whereas the use of the new hybrid technique PET-MRI is still under evaluation. Since criteria that may preclude optimal cytoreductive surgery may vary, depending on the aggressiveness of the surgical procedure and surgeon skill, multidisciplinary consensus conferences are the ideal platform to evaluate extent of the disease and surgical strategy.

  • ovarian neoplasms
  • surgical oncology

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Footnotes

  • Contributors SR, LM, and FDG contributed substantially to the conception and design of the work. SR, LM, MDG, and AP drafted the manuscript and revised it critically for important intellectual content. SR, MDG, LM, AP, and FDG approved the final version prior to submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.