An image of ovarian cancer cells. A new study suggests ultrasound assessment of lesions in the ovaries can help identify women at risk for the disease. File photo by Vshivkova/Shutterstock
March 22 (UPI) — Ovarian lesions seen on ultrasound can help predict cancer risk and help women avoid unnecessary surgery, a study published Tuesday by the journal Radiology found.
The ultrasound-based approach was 93% accurate at identifying potentially cancerous lesions in nearly 900 women at average risk for the disease, the data showed.
It correctly identified those not at risk for developing ovarian cancer 73% of the time, the researchers said.
“Ultimately, we’re hoping that by using the ultrasound features we can triage which patients need follow-up imaging with ultrasound or MRI and which patients should be referred to surgery,” study co-author Dr. Akshya Gupta said in a press release.
“There is a lot of nuance to it because the lesions can be challenging to assess,” said Gupta, an assistant professor of imaging sciences at the University of Rochester Medical Center in Rochester, N.Y.
Ovarian cancer is the deadliest of the gynecologic cancers in the United States, as it kills approximately 15,000 women every year, according to the Centers for Disease Control and Prevention.
Being able to spot and assess adnexal lesions, or lumps near the uterus, on ultrasound is crucial for determining cancer risk and identifying women who may need surgery to remove them, Gupta and his colleagues said.
Some adnexal lesions progress to cancer, while many others are benign and do not require treatment, they said.
Previous studies have found that most benign ovarian cysts do not require treatment or surgical removal.
“Based on the characteristics that we see on ultrasound, we try to evaluate if a finding needs further workup and where the patient should go from there,” Gupta said.
For this study, Gupta and his colleagues assessed a method that uses ultrasound images to classify adnexal lesions into one of two categories: classic or non-classic.
Classic lesions are those that are commonly detected, such as fluid-filled cysts that carry a very low risk for developing into cancerous tumors, the researchers said.
Non-classic lesions, which are more likely to become cancerous, include those with a solid component and blood flow detected on Doppler ultrasound, they said.
Patients with classic benign lesions generally do not require further assessment or treatment, according to the researchers.
Using their ultrasound-based approach, they assessed 970 isolated adnexal lesions in 878 women, most of whom were in their late 30s or early 40s and considered to be at average risk of ovarian cancer.
This means they had no family history or genetic markers linked with the disease, the researchers said.
Of the 970 lesions, 53, or 6%, were malignant, according to the researchers.
The approach used in the study correctly identified malignant lesions 93% of the time, while accurately spotting benign ones 73% of the time, the data showed.
The frequency of malignancy was less than 1% in lesions with classic ultrasound features, compared with 32% in non-classic lesions, the researchers said.
In participants age 60 years and older, 50% of non-classic lesions developed into malignant tumors, they said.
Ultrasound has not been proven specifically as a screening exam for ovarian cancer, they said.
Still, if additional research supports the study findings, then this system could become a useful tool for radiologists that would spare many women the costs, stress and complications of surgery, according to the researchers.
“If you have something that follows the classic imaging patterns described for these lesions, then the risk of cancer is really low,” Gupta said.
“If you have something that’s not classic in appearance, then the presence of solid components and particularly the presence of Doppler blood flow is really what drives the risk of malignancy,” he said.
