Substantial discordance between structured pre-operative computed tomography (CT) reports and intraoperative findings in advanced ovarian cancer cytoreductive surgery, affecting treatment decisions

IF 2 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology Pub Date : 2026-02-01 Epub Date: 2025-12-13 DOI:10.1016/j.crad.2025.107214

M. Kengsakul , H.J. van Beekhuizen , A. Bijleveld , D.C. Plak , B.M. de Kok , I.G. Schoots , J.M.J. Piek , S.J. Kerr , M.G.J. Thomeer , G.M. Nieuwenhuyzen-de Boer

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引用次数: 0

Abstract

AIM

The aim of this study was to assess the agreement and diagnostic accuracy of structured preoperative computed tomography (CT) findings compared to intraoperative findings in advanced ovarian cancer patients undergoing primary or interval cytoreductive surgery.

MATERIALS AND METHODS

Patients with CT scans suggesting advanced ovarian cancer were enrolled in the study. Agreement between CT reports, reviewed using European Society of Urogenital Radiology (ESUR) criteria, and surgical findings were evaluated with the kappa coefficient. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each radiologic feature.

RESULTS

From February 2018 to September 2020, 258 patients with International Federation of Gynaecology and Obstetrics (FIGO) stage IIIB-IV epithelial ovarian cancer were enrolled. Agreement between ESUR-reviewed CT reports and surgical findings was slight to fair (kappa = 0.115–0.352). The most common CT findings were peritoneal carcinomatosis, omental metastases, and bowel involvement. Sensitivity and specificity of peritoneal carcinomatosis were 0.91 (95% confidence interval [CI]: 0.86–0.94) and 0.19 (95% CI: 0.10–0.31), with an area under the receiver operating characteristic curve (AUC) of 0.55 (95% CI: 0.46–0.64). Omental metastases had a sensitivity of 0.91 (95% CI: 0.87–0.95) and specificity of 0.27 (95% CI: 0.16–0.40) with an AUC of 0.59 (95% CI: 0.52–0.65). Bowel involvement showed a sensitivity of 0.61 (95% CI: 0.54–0.67), specificity of 0.71 (95% CI: 0.58–0.83), and AUC of 0.66 (95% CI: 0.58–0.74).

CONCLUSION

This study demonstrates limited concordance between ESUR-reviewed CT reports and intraoperative findings in advanced ovarian cancer. Even when interpreted by expert radiologists, CT imaging alone may inadequately reflect disease burden. These findings emphasise the ongoing challenges of imaging-based surgical planning and support the need for further development and validation of more accurate preoperative assessment tools.

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在晚期卵巢癌细胞减少手术中，结构化的术前计算机断层扫描（CT）报告与术中发现之间存在实质性的不一致，影响治疗决策。

目的：本研究的目的是评估术前结构化计算机断层扫描（CT）结果与行原发性或间隔期细胞减少手术的晚期卵巢癌患者术中结果的一致性和诊断准确性。材料和方法：CT扫描提示晚期卵巢癌的患者入组研究。采用欧洲泌尿生殖系统放射学会（ESUR）标准审查CT报告与手术结果之间的一致性，用kappa系数进行评估。计算每个放射学特征的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。结果：2018年2月至2020年9月，纳入258例国际妇产科联合会（FIGO） iii期b - iv期上皮性卵巢癌患者。esur复查CT报告与手术结果的一致性为轻微到一般（kappa = 0.115-0.352）。最常见的CT表现为腹膜癌、大网膜转移和肠受累。腹膜癌的敏感性和特异性分别为0.91（95%可信区间[CI]: 0.86-0.94）和0.19 (95% CI: 0.10-0.31)，受者工作特征曲线下面积（AUC）为0.55 （95% CI: 0.46-0.64）。网膜转移的敏感性为0.91 (95% CI: 0.87-0.95)，特异性为0.27 (95% CI: 0.16-0.40)， AUC为0.59 （95% CI: 0.52-0.65）。肠受累的敏感性为0.61 (95% CI: 0.54-0.67)，特异性为0.71 (95% CI: 0.58-0.83)， AUC为0.66 （95% CI: 0.58-0.74）。结论：本研究显示晚期卵巢癌的esur复查CT报告与术中发现有一定的一致性。即使由放射科专家解释，单独的CT成像也不能充分反映疾病负担。这些发现强调了基于成像的手术计划的持续挑战，并支持进一步开发和验证更准确的术前评估工具的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical radiology 医学-核医学

CiteScore

4.70

自引率

3.80%

发文量

528

审稿时长

76 days

期刊介绍： Clinical Radiology is published by Elsevier on behalf of The Royal College of Radiologists. Clinical Radiology is an International Journal bringing you original research, editorials and review articles on all aspects of diagnostic imaging, including: • Computed tomography • Magnetic resonance imaging • Ultrasonography • Digital radiology • Interventional radiology • Radiography • Nuclear medicine Papers on radiological protection, quality assurance, audit in radiology and matters relating to radiological training and education are also included. In addition, each issue contains correspondence, book reviews and notices of forthcoming events.