Ultrasound-based Screening for Ovarian Cancer
Author: Dror Nir, PhD
Occasionally, I check for news on ovarian cancer screening. I do that for sentimental reasons; I started the HistoScanning project aiming to develop an effective ultrasound-based screening solution for this cancer.
As awareness for ovarian cancer is highest in the USA, I checked for the latest news on the NCI web-site. I found that to-date: “There is no standard or routine screening test for ovarian cancer. Screening for ovarian cancer has not been proven to decrease the death rate from the disease.
Screening for ovarian cancer is under study and there are screening clinical trials taking place in many parts of the country. Information about ongoing clinical trials is available from the NCI Web site.”
I also found that:
Estimated new cases and deaths from ovarian cancer in the United States in 2013:
- New cases: 22,240
- Deaths: 14,030
To get an idea on the significance of these numbers, lets compare them to the numbers related to breast cancer:
Estimated new cases and deaths from breast cancer in the United States in 2013:
- New cases: 232,340 (female); 2,240 (male)
- Deaths: 39,620 (female); 410 (male)
Death rate of ovarian cancer patients is almost 4 times higher than the rate in breast cancer patients!
Therefore, I decided to raise awareness to the results achieved for ovarian HistoScanning in a double-blind multicenter European study that was published in European Radiology three years ago. The gynecologists who recruited patients to this study used standard ultrasound machines of GE-Medical. I would like as well to disclose that I am one of the authors of this paper:
A new computer-aided diagnostic tool for non-invasive characterisation of malignant ovarian masses: results of a multicentre validation study, Olivier Lucidarme et.al., European Radiology, August 2010, Volume 20, Issue 8, pp 1822-1830
Abstract
Objectives
To prospectively assess an innovative computer-aided diagnostic technology that quantifies characteristic features of backscattered ultrasound and theoretically allows transvaginal sonography (TVS) to discriminate benign from malignant adnexal masses.
Methods
Women (n = 264) scheduled for surgical removal of at least one ovary in five centres were included. Preoperative three-dimensional (3D)-TVS was performed and the voxel data were analysed by the new technology. The findings at 3D-TVS, serum CA125 levels and the TVS-based diagnosis were compared with histology. Cancer was deemed present when invasive or borderline cancerous processes were observed histologically.
Results
Among 375 removed ovaries, 141 cancers (83 adenocarcinomas, 24 borderline, 16 cases of carcinomatosis, nine of metastases and nine others) and 234 non-cancerous ovaries (107 normal, 127 benign tumours) were histologically diagnosed. The new computer-aided technology correctly identified 138/141 malignant lesions and 206/234 non-malignant tissues (98% sensitivity, 88% specificity). There were no false-negative results among the 47 FIGO stage I/II ovarian lesions. Standard TVS and CA125 had sensitivities/specificities of 94%/66% and 89%/75%, respectively. Combining standard TVS and the new technology in parallel significantly improved TVS specificity from 66% to 92% (p < 0.0001).
An example of an ovary considered to be normal with TVS.
The same TVS
false-negative ovary with OVHS-detected foci of malignancy. The presence of an
adenocarcinoma was confirmed histologically.
Conclusions
Computer-aided quantification of backscattered ultrasound is highly sensitive for the diagnosis of malignant ovarian masses.
Personal note:
Based on this study a promising offer for ultrasound-based screening method for ovarian cancer was published in: Int J Gynecol Cancer. 2011 Jan;21(1):35-43. doi: 10.1097/IGC.0b013e3182000528.: Mathematical models to discriminate between benign and malignant adnexal masses: potential diagnostic improvement using ovarian HistoScanning. Vaes E, Manchanda R, Nir R, Nir D, Bleiberg H, Autier P, Menon U, Robert A.
Regrettably, the results of these studies were never transformed into routine clinical products due to financial reasons.
Other research papers related to the management of Prostate cancer were published on this Scientific Web site:
Beta-Blockers help in better survival in ovarian cancer
Ovarian Cancer and fluorescence-guided surgery: A report
Role of Primary Cilia in Ovarian Cancer
Squeezing Ovarian Cancer Cells to Predict Metastatic Potential: Cell Stiffness as Possible Biomarker
Warning signs may lead to better early detection of ovarian cancer
[…] Ultrasound-based screening for ovarian cancer. […]
Dr. Nir,
Thank you for this interesting article. This is the ideal case, indeed, the author was the researcher, or one member of a Team, has already published the results in a Scientific Journal and is now publishing the results in an Open Access Online Scientific Journal for e-Readership enjoying the benefit od Search ENgines by Subject matter.
I believe that you plan to add this article to the Ultrasound Chapter of yours in our forthcoming Cancer e-Book. You are the Editor of your own Chapters in this e-Book in coordination with all the Editors.
Great work, sensible initiative and leadership in an area, you are reporting no screening standards in place, thus, potential for policy impact.
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