Ovarian cancer forms in the ovaries, the female reproductive glands responsible for producing eggs. If not detected and treated early, this disease can spread to other parts of the body. Medical imaging creates pictures of the body’s interior, providing information about pelvic masses and potential spread, which is significant for understanding and managing ovarian cancer.
Common Imaging Methods
Ultrasound is often the initial imaging test for suspected ovarian issues. This method uses high-pitched sound waves emitted from a small transducer, moved over the abdomen or inserted into the vagina for a transvaginal ultrasound. The sound waves bounce off internal organs, and a computer converts the echoes into an image, allowing doctors to visualize the ovaries and surrounding structures.
Computed Tomography (CT) scans utilize X-ray technology to produce detailed cross-sectional images of the body. A CT scanner rotates around the patient, taking multiple pictures from various angles, which a computer then combines to create detailed views of internal organs, bones, and soft tissues. This imaging is useful for evaluating disease extent and detecting if cancer has spread to other organs or lymph nodes.
Magnetic Resonance Imaging (MRI) scans generate cross-sectional images using strong magnets and radio waves instead of X-rays. A contrast material, such as gadolinium, may be injected to enhance tissue visibility. MRI provides detailed images that can help differentiate between benign and malignant masses, especially when other imaging results are inconclusive.
Positron Emission Tomography (PET) scans involve injecting a radioactive sugar tracer into the bloodstream. Cancer cells, which have a higher metabolic rate, absorb more of this sugar, making them appear as bright spots on the scan. The scan highlights areas of increased metabolic activity, which can indicate the location and extent of cancerous cells.
What Ovarian Cancer Images Show
Ultrasound and CT Findings
Ovarian cancer images often display specific characteristics that help assess malignancy. On ultrasound, suspicious masses may appear large, have papillary structures or bulges, or be divided into multiple segments called loculations. The presence of blood or other internal material can also provide clues about its nature.
CT scans can identify larger tumors and reveal complex cystic and solid lesions with features like thick walls or areas of tissue death. These scans also show signs of metastatic spread, such as enlarged lymph nodes, liver involvement, peritoneal disease with fluid buildup (ascites), or tumor extension to nearby organs.
MRI and Doppler/PET Findings
MRI scans provide highly detailed images that distinguish between fluid, solid tissue, fat, and hemorrhage within a mass. Radiologists look for features such as thick septations (internal divisions) and papillary projections (tissue growths). A thick outer wall and the presence of necrosis also suggest a malignant tumor.
The vascular characteristics of a mass, as observed with Doppler ultrasound, can offer insights. Malignant lesions often show increased neovascularization (new blood vessel formation), resulting in a significant increase in color Doppler flow signals. This heightened blood flow, appearing as brighter areas on PET scans due to increased metabolic activity, can further support the suspicion of cancer.
How Imaging Guides Care
Imaging helps diagnose ovarian cancer, often beginning with ultrasound to identify suspicious masses. If an abnormality is suggested, further imaging like CT or MRI provides more detailed information about the mass and its relationship to surrounding structures. These images provide clues but do not offer a definitive diagnosis, which typically requires a biopsy.
For disease staging, CT scans of the chest, abdomen, and pelvis determine if cancer has spread beyond the ovaries. This detailed mapping helps assign a disease stage, from stage 1 (confined to the ovaries) to stage 4 (spread to distant areas). MRI can also be used for staging, particularly for visualizing lymph nodes.
Imaging also guides biopsy procedures, which confirm a cancer diagnosis. For advanced cancer where immediate surgery is not feasible, an image-guided needle biopsy can be performed. A radiologist uses ultrasound or CT guidance to direct a needle into the suspected tumor or metastatic site to collect tissue samples.
Imaging also aids in planning surgical interventions by predicting tumor resectability (how much can be safely removed). After treatment, such as chemotherapy, imaging tests monitor therapy effectiveness by observing changes in tumor size or new cancerous areas. This ongoing monitoring helps clinicians make informed decisions about treatment strategies.