Role of computed tomography (CT) in prediction of histological subtypes of epithelial ovarian carcinoma.

Malik, Navdeep; Sinha, Upasna; kumar, Prem; Sinha, Ruchi; Pandey, Jagjit Kumar; Kumari, Sangam

Introduction: According to the 2018 Globocan Fact Sheet, 3.44 percent (36170) of all cancer cases in India's female population were attributable to ovarian cancer, making it the seventh most common cancer in females worldwide. Patients with type I ovarian carcinoma have a substantially longer overall survival duration than those with type II ovarian carcinoma. Type II epithelial ovarian carcinoma is a more aggressive form of the disease, which also progresses quickly and is associated with a lower likelihood of overall survival. Aims and Objectives: To assess the role of CT in the prediction of different histological subtypes of epithelial ovarian carcinoma. Material and Methods: The present prospective observational study was carried out in the Department of Radiodiagnosis, All India Institute of Medical Sciences (AIIMS) Patna from January 2022 and May 2023. This study investigated a group of 41 patients with ovarian carcinoma. Results: Of the total 41 sample size, 28 patients (68%) were diagnosed with type II epithelial ovarian cancer, while 13 patients (32%) diagnosed with type I epithelial ovarian carcinoma. Patients diagnosed with type I epithelial ovarian cancers (EOCs) exhibit a higher likelihood of affecting younger individuals and demonstrate lower levels of the CA-125 biomarker in their serum. Type II epithelial ovarian cancers (EOCs) often have solid-cystic or mostly solid bilateral masses that are smaller in size and display mild enhancement on contrast-enhanced computed tomography (CECT) imaging, in contrast to type I EOCs. The presence of diffuse omentum involvement, peritoneal deposits, and metastatic lymphadenopathy was more frequently observed in type II epithelial ovarian cancer (EOC) in comparison to type I EOC. In comparison to type I epithelial ovarian cancer (EOC), type II EOC typically has irregular margins and is more frequently accompanied by pleural effusion. Conclusion: Ovarian cancer of epithelial origin has diverse imaging characteristics that vary based on the level of differentiation and histological subtypes. In general, the study sheds light on CT imaging parameters that help differentiate histological subtypes of epithelial ovarian carcinoma into type I and type II which will guide clinicians in deciding appropriate treatment strategy as well as prognostication of patient. The findings of the present study contribute to a better understanding of the morphology, enhancement, laterality, size, and dissemination patterns of different subtypes of epithelial ovarian carcinoma. Present study recommends that a radiologist must be familiar with these specific patterns for better interpretation of images and to suggest adequate management for patients of ovarian carcinoma.

OVARIAN epithelial cancer; COMPUTED tomography; OVARIAN cancer; IMAGE analysis; OVERALL survival

Pravara Medical Review, 2024, Vol 16, Issue 4, p49

0975-0533

Academic Journal

10.36848/PMR/2024/044000.10455