Discrepancy Between Preoperative Imaging and Surgical Findings in Patients With Advanced Ovarian Cancer: A Study of Initial False-Negative Lesions

Abstract

OBJECTIVE: The objective of this study was to determine the patterns of erroneous interpretation of preoperative computed tomography (CT) for detection of peritoneal lesions in advanced ovarian cancer. METHODS: Between 2007 and 2011, 148 patients with International Federation of Gynecology and Obstetrics stage IIIC-IV ovarian cancer, who underwent multi-detector-row CT before primary cytoreduction, were enrolled. We reviewed the preoperative CT and compared the findings with the surgical findings. For the discrepant cases, false-negative cases were reevaluated after revealing of surgical findings and were categorized as either absence or presence of lesion (missed case). We performed region-based comparisons according to predefined peritoneal lesion locations. RESULTS: Sixty-eight false-negative cases were identified, of which 43 were revealed to be initially missed cases. The most common locations were found to be the small-bowel mesentery (21%), subdiaphragmatic space (19%), and porta hepatis (16%). CONCLUSIONS: The missed peritoneal implants commonly resided in the same sites of preoperative imaging criteria that could predict suboptimal primary cytoreduction.