Martina Borčinová

Patient satisfaction with ultrasound, whole-body CT and whole-body diffusion-weighted MRI for pre-operative ovarian cancer staging: a multicenter prospective cross-sectional survey

In addition to the diagnostic accuracy of imaging methods, patient-reported satisfaction with imaging methods is important. To report a secondary outcome of the prospective international multicenter Imaging Study in Advanced ovArian Cancer (ISAAC Study), detailing patients' experience with abdomino-pelvic ultrasound, whole-body contrast-enhanced computed tomography (CT), and whole-body diffusion-weighted magnetic resonance imaging (WB-DWI/MRI) for pre-operative ovarian cancer work-up. In total, 144 patients with suspected ovarian cancer at four institutions in two countries (Italy, Czech Republic) underwent ultrasound, CT, and WB-DWI/MRI for pre-operative work-up between January 2020 and November 2022. After having undergone all three examinations, the patients filled in a questionnaire evaluating their overall experience and experience in five domains: preparation before the examination, duration of examination, noise during the procedure, radiation load of CT, and surrounding space. Pain perception, examination-related patient-perceived unexpected, unpleasant, or dangerous events ('adverse events'), and preferred method were also noted. Ultrasound was the preferred method by 49% (70/144) of responders, followed by CT (38%, 55/144), and WB-DWI/MRI (13%, 19/144) (p7 of 10) during the ultrasound examination. We did not identify any factors related to patients' preferred method. Ultrasound was the imaging method preferred by most patients despite being associated with more pain during the examination in comparison with CT and WB-DWI/MRI. NCT03808792.

Pre-surgical Tru-Cut biopsy of sonographically atypical myometrial lesions: A prospective pilot study

This study aimed to evaluate the feasibility and safety of Tru-Cut biopsy as a complementary diagnostic tool in the pre-operative evaluation of sonographically atypical myometrial lesions in patients scheduled for uterine surgery. Secondary objectives included determining the diagnostic accuracy, sensitivity, and specificity of Tru-Cut biopsy in pre-operative tumor characterization and patient's perceived peri-procedural pain. In this pilot study, all consecutive patients aged ≥18 years with atypical myometrial lesions based on ultrasonography referred to our institution's Centre of Minimally Invasive Surgery between June 2022 and June 2023 underwent pre-operative trans-vaginal or trans-cervical ultrasound-guided Tru-Cut biopsy, followed by surgical treatment. Samples were considered adequate if histologic tumor typing was possible. Diagnostic accuracy was determined by comparing Tru-Cut biopsy histology with final post-operative histology. Of 39 patients who underwent Tru-Cut biopsy, 27 (69.2%) were diagnosed with conventional leiomyoma, 9 (23.1%) with benign atypical myometrial lesion, 1 (2.6%) with smooth muscle tumor of uncertain malignant potential, and 2 (5.1%) had inadequate samples. The median pain score immediately post-Tru-Cut biopsy was 4 (interquartile range; 3-5), with no pain reported 24 hours later. Complications occurred in 2 patients (5.2%): 1 required hospitalization for collapse and another underwent laparoscopic intervention for abdominal bleeding. Among the 37 adequate samples, Tru-Cut biopsy findings were concordant with final histology in 34 cases (diagnostic accuracy 91.9%; 95% confidence interval [CI] 78.7 to 97.2). Tru-Cut biopsy sensitivity and specificity were 88.9% (95% CI 56.5 to 98.0) and 92.9% (95% CI 77.4 to 98.0), respectively. This pilot study indicates that Tru-Cut biopsy is a feasible, safe, and accurate method for pre-operative assessment of atypical myometrial lesions, providing histologically adequate samples for diagnostic evaluation. Larger studies are warranted to validate these results.

Imaging Study in Advanced Ovarian Cancer

The aim of the study is the assessment of tumour sites critical for the achievement of optimal cytoreduction in patients with advanced ovarian cancer using Ultrasound, CT and WB-DWI/MRI. The study uses an equivalence design with a hypothesis that cases with non-resectable disease identified by Index test (Ultrasound, CT and WB-DWI MRI) are equivalent to a portion of cases identified during surgery.