Katherine E. Maturen

Gynecologic Manifestations of Hereditary Syndromes: Clinical and Imaging Spectrum

The role of imaging in the diagnosis of gynecologic manifestations of hereditary syndromes is important and allows evaluation of key imaging features and associated conditions.

Incidental Adnexal Lesions: CT Diagnosis and Interreader Agreement

Even among nine expert readers, CT diagnosis was not reproducible and was frequently incorrect for most adnexal lesion types, excluding dermoids, malignant ovarian lesions with metastases, and simple cysts.

The Ovarian-Adnexal Reporting and Data System (O-RADS) US Score Effect on Surgical Resection Rate

Among ovarian and adnexal lesions surgically removed before 2015, a large proportion were retrospectively assessed as Ovarian-Adnexal Imaging Reporting and Data System US 2, which may have allowed for more conservative management in these patients.

The Roles of Ovarian-Adnexal Reporting and Data System US and Ovarian-Adnexal Reporting and Data System MRI in the Evaluation of Adnexal Lesions

Ovarian-Adnexal Reporting and Data System US and MRI provide evidence-based lexicons and risk assessment systems that can accurately diagnose most adnexal lesions as benign and effectively risk stratify those that are suspicious for malignancy.

Neoadjuvant chemotherapy for high-grade serous ovarian cancer: radiologic–pathologic correlation of response assessment and predictors of progression

Neoadjuvant chemotherapy is often administered for high-grade serous ovarian carcinoma (HGSC) prior to cytoreductive surgery. We evaluated treatment response by CT (simplified peritoneal carcinomatosis index [S-PCI]), pathology (chemotherapy response score [CRS]), laboratory markers (serum CA-125), and surgical outcomes, to identify predictors of disease-free survival. For this retrospective, HIPAA-compliant, IRB-approved study, we identified 396 women with HGSC receiving neoadjuvant chemotherapy between 2010 and 2019. Two hundred and ninety-nine patients were excluded (surgery not performed; imaging/pathology unavailable). Pre- and post-treatment abdominopelvic CTs were assigned CT S-PCI scores 0-24 (higher score indicating more tumor). Specimens were assigned CRS of 1-3 (minimal to complete response). Clinical data were obtained via chart review. Univariate, multivariate, and survival analyses were performed. Ninety-seven women were studied, with mean age of 65 years ± 10. Interreader agreement was good to excellent for CT S-PCI scores (ICC 0.64-0.77). Despite a significant decrease in CT S-PCI scores after treatment (p < 0.001), mean decrease in CT S-PCI did not differ significantly among CRS categories (p = 0.20) or between patients who were optimally versus suboptimally debulked (p = 0.29). In a survival analysis, lower CRS (more viable tumor) was associated with shorter time to progression (p < 0.001). A joint Cox proportional-hazard models showed that only residual pathologic disease (CRS 1/2) (HR 4.19; p < 0.001) and change in CA-125 (HR 1.79; p = 0.01) predicted progression. HGSC response to neoadjuvant therapy by CT S-PCI did not predict pathologic CRS score, optimal debulking, or progression, revealing discordance between imaging, pathologic, biochemical, and surgical assessments of tumor response.