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Original research
Patient satisfaction with ultrasound, whole-body CT and whole-body diffusion-weighted MRI for pre-operative ovarian cancer staging: a multicenter prospective cross-sectional survey
  1. Patrícia Pinto1,2,
  2. Lil Valentin3,4,
  3. Martina Borčinová5,
  4. Markéta Wiesnerová6,
  5. Fruhauf Filip5,
  6. Andrea Burgetova7,
  7. Martin Masek7,
  8. Lukas Lambert7,
  9. Valentina Chiappa8,
  10. Dorella Franchi9,
  11. Antonia Carla Testa10,11,
  12. Francesca Moro11,
  13. Giacomo Avesani12,
  14. Camilla Panico12,
  15. Sarah Alessi13,
  16. Paola Pricolo13,
  17. Raffaella Vigorito14,
  18. Giuseppina Calareso14,
  19. Roman Kocian5,
  20. Jiri Slama5,
  21. Anna Fagotti11,
  22. Ailyn Mariela Vidal Urbinati15,
  23. Mauro Signorelli8,
  24. Francesca Bertolina8,
  25. David Cibula5 and
  26. Daniela Fischerova5
    1. 1Department of Gynecology, Portuguese Institute of Oncology of Lisbon Francisco Gentil, Lisboa, Portugal
    2. 2First Faculty of Medicine, Charles University, Prague, Czech Republic
    3. 3Department of Obstetrics and Gynaecology, Skane University Hospital, Malmo, Sweden
    4. 4Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
    5. 5Gynecologic Oncology Centre, Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
    6. 6Masaryk University Institute of Biostatistics and Analyses, Brno, Czech Republic
    7. 7Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
    8. 8Department of Gynecologic Oncology, Foundation IRCCS National Cancer Institute, Milan, Italy
    9. 9Preventive Gynecology Unit, Division of Gynaecology, European Institute of Oncology, Milan, Italy
    10. 10Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
    11. 11Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Lazio, Italy
    12. 12Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Lazio, Italy
    13. 13Division of Radiology, Istituto Europeo di Oncologia, Milan, Italy
    14. 14Department of Radiology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
    15. 15Preventive Gynecology Unit, Division of Gynecology, European Institute of Oncology, Milan, Italy
    1. Correspondence to Professor Daniela Fischerova, Gynecologic Oncology Center, Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague 2 12108, Czech Republic; daniela.fischerova{at}vfn.cz

    Abstract

    Background In addition to the diagnostic accuracy of imaging methods, patient-reported satisfaction with imaging methods is important.

    Objective To report a secondary outcome of the prospective international multicenter Imaging Study in Advanced ovArian Cancer (ISAAC Study), detailing patients’ experience with abdomino-pelvic ultrasound, whole-body contrast-enhanced computed tomography (CT), and whole-body diffusion-weighted magnetic resonance imaging (WB-DWI/MRI) for pre-operative ovarian cancer work-up.

    Methods In total, 144 patients with suspected ovarian cancer at four institutions in two countries (Italy, Czech Republic) underwent ultrasound, CT, and WB-DWI/MRI for pre-operative work-up between January 2020 and November 2022. After having undergone all three examinations, the patients filled in a questionnaire evaluating their overall experience and experience in five domains: preparation before the examination, duration of examination, noise during the procedure, radiation load of CT, and surrounding space. Pain perception, examination-related patient-perceived unexpected, unpleasant, or dangerous events (‘adverse events’), and preferred method were also noted.

    Results Ultrasound was the preferred method by 49% (70/144) of responders, followed by CT (38%, 55/144), and WB-DWI/MRI (13%, 19/144) (p<0.001). The poorest experience in all domains was reported for WB-DWI/MRI, which was also associated with the largest number of patients who reported adverse events (eg, dyspnea). Patients reported higher levels of pain during the ultrasound examination than during CT and WB-DWI/MRI (p<0.001): 78% (112/144) reported no pain or mild pain, 19% (27/144) moderate pain, and 3% (5/144) reported severe pain (pain score >7 of 10) during the ultrasound examination. We did not identify any factors related to patients' preferred method.

    Conclusion Ultrasound was the imaging method preferred by most patients despite being associated with more pain during the examination in comparison with CT and WB-DWI/MRI.

    Trial registration number NCT03808792.

    • Ovarian Cancer
    • Preoperative Care
    • Cross-Sectional Studies

    Data availability statement

    All data relevant to the study are included in the article or uploaded as supplementary information.

    https://doi.org/10.1136/ijgc-2023-005264

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      Data availability statement

      All data relevant to the study are included in the article or uploaded as supplementary information.

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      Footnotes

      • PP and LV are joint first authors.

      • Twitter @PatriciaPint0

      • Presented at The data reported in this manuscript have been presented at the European Society of Gynecological Oncology 2023 Congress (International Journal of Gynecologic Cancer 2023;33:A118.).

      • Contributors PPi and LV are joint first authors; PPi and DFi were responsible for the design of the study; PPi and LV were responsible for the manuscript writing; DFi contributed to the critical evaluation of tables, figures, and manuscript writing; DFi is the guarantor; MB and MW were responsible for the statistical analysis; DFi, FF, AB, MM, LL, VC, DFr, ACT, FM, GA, CP, SA, PPr, RV, GC, RK, JS, AF, AMVU, MS, FB, and DC participated in the acquisition and analysis of data for the work; all authors were included in drafting the work or revising it critically for important intellectual content; all authors have read and agreed to the published version of the manuscript.

      • Funding This research was supported by Ministry of Health of the Czech Republic (NV19-03-00552), by the Charles University in Prague (UNCE/24/MED/018), by the Charles University Research program “Cooperatio – Maternal and Childhood Care; Neonatology”, and by the institutional grant of The General University Hospital in Prague (CZ-DRO-VFN64165).

      • Competing interests None declared.

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

      • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.