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Multidetector CT Finds Peritoneal Ovarian Cancer Metastasis

Multidetector CT Finds Peritoneal Ovarian Cancer Metastasis

ATLANTA—Ovarian cancer that has metastasized to the abdomen and pelvis can
be effectively identified by thin-slice dual-phase imaging and 3D
reconstruction with multidetector CT (MDCT) scanning, a technique that appears
to be more sensitive and faster than spiral and conventional CT scanners, a new
study suggests.

Elliot K. Fishman, MD, professor of radiology and director of Diagnostic
Imaging and Body CT, Johns Hopkins University, and his colleagues presented
their study results at a poster session of the 102nd Annual Meeting of the American
Roentgen Ray Society (ARRS abstract 259).

Peritoneal metastases are the most common types of metastases from ovarian
cancer; they are also the most difficult to detect because of their small size.
Dr. Fishman and his colleagues report that MDCT was able to identify metastatic
disease at sites, such as the stomach, porta hepatis, and gallbladder fossa,
where they may often be overlooked at surgery.

Previous studies have shown that the maximum sensitivity of spiral and
conventional CT scanners for detecting peritoneal metastases of ovarian cancer
is no more than 80%, and specificity is no more than 85%. Furthermore,
sensitivity is only 50% for 5 mm lesions and 28% for lesions less than 3 mm in

Possible factors responsible for these low sensitivities, Dr. Fishman said,
include the inability to image thin sections through the large volume of tissue
from the diaphragm to the pubic symphysis because of pitch restrictions and
tube heating.

"Typically, sections of 5 mm to 8 mm are obtained, which may be larger
than the size of the metastatic deposit," he said. "Another reason is
partial volume averaging of structures oblique or parallel to the axial plane,
such as the diaphragm, which can limit visualization."

The Johns Hopkins researchers evaluated the MDCT technique by analyzing 31
thin-slice dual-phase examinations of the abdomen and pelvis conducted in 27
patients diagnosed with ovarian cancer over a 10-month period.


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