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Brief Summary

GUIDELINE TITLE

Diagnostic imaging in the assessment of metastatic and recurrent ovarian cancer.

BIBLIOGRAPHIC SOURCE(S)

  • Cancer Care Ontario (CCO). Diagnostic imaging in the assessment of metastatic and recurrent ovarian cancer. Toronto (ON): Cancer Care Ontario (CCO); 2006 Apr 7. 14 p. [15 references]

GUIDELINE STATUS

This is the current release of the guideline.

Please visit the Cancer Care Ontario Web site for details on any new evidence that has emerged and implications to the guidelines.

BRIEF SUMMARY CONTENT

 RECOMMENDATIONS
 EVIDENCE SUPPORTING THE RECOMMENDATIONS
 IDENTIFYING INFORMATION AND AVAILABILITY
 DISCLAIMER

 Go to the Complete Summary

RECOMMENDATIONS

MAJOR RECOMMENDATIONS

These recommendations were developed by radiology and oncology experts in Ontario and are informed by research evidence and clinical expertise.

Clinical/Diagnostic Problem Investigation Recommendation (Grade) Comment Band*
Local Staging Computed tomography (CT) Indicated (primary) Best modality to stage abdomen and pelvis concurrently III
Magnetic resonance imaging (MRI) Indicated (supplementary) Use when:
  1. CT contraindicated.
  2. Adnexal lesion detected by US or CT needs additional characterization.
  3. Extent of local invasiveness needs better delineation.
 0
Ultrasound (US) Not indicated While many adnexal lesions are initially detected by US, staging is limited by limited field of view and bowel gas 0
Recurrence CT Indicated (primary) See peritoneal metastases (recurrence usually in peritoneal cavity and retroperitoneum) IV
MRI Indicated (supplementary) See peritoneal metastases 0
US Not indicated See peritoneal metastases 0
Peritoneal Metastases CT Indicated (primary) See suggested protocol IV
MRI Indicated (supplementary) Use when:
  1. CT contraindicated (e.g., contrast allergy)
  2. Highest sensitivity needed (CA 125 positive but CT negative)
 0
US Not indicated Sensitivity limited by bowel gas Limited reproducibility 0
Follow-up Decisions regarding follow-up imaging must be done on a patient by patient basis

*Band classification of the typical effective doses of ionizing radiation from common imaging procedures

Band Typical effective dose (mSv) Examples
0 0 US, MRI
I Less than 1 Chest x-ray (CXR), XR limb, XR pelvis
II 1 to 5 Intravenous urography (IVU), XR lumber spine, nuclear medicine (NM) (e.g., skeletal scintigram), CT head and neck
III 5 to 10 CT chest or abdomen, NM (e.g., cardiac)
IV More than 10 Extensive CT studies, some NM studies (e.g., some positron emission tomography [PET])

CLINICAL ALGORITHM(S)

None provided

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EVIDENCE SUPPORTING THE RECOMMENDATIONS

TYPE OF EVIDENCE SUPPORTING THE RECOMMENDATIONS

The recommendations are supported by case series.

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IDENTIFYING INFORMATION AND AVAILABILITY

BIBLIOGRAPHIC SOURCE(S)

  • Cancer Care Ontario (CCO). Diagnostic imaging in the assessment of metastatic and recurrent ovarian cancer. Toronto (ON): Cancer Care Ontario (CCO); 2006 Apr 7. 14 p. [15 references]

ADAPTATION

Not applicable: The guideline was not adapted from another source.

DATE RELEASED

2006 Apr 7

GUIDELINE DEVELOPER(S)

Program in Evidence-based Care - State/Local Government Agency [Non-U.S.]

GUIDELINE DEVELOPER COMMENT

The Program in Evidence-based Care (PEBC) is a Province of Ontario initiative sponsored by Cancer Care Ontario and the Ontario Ministry of Health and Long-Term Care.

SOURCE(S) OF FUNDING

Cancer Care Ontario
Ontario Ministry of Health and Long-Term Care

GUIDELINE COMMITTEE

Not stated

COMPOSITION OF GROUP THAT AUTHORED THE GUIDELINE

Not stated

FINANCIAL DISCLOSURES/CONFLICTS OF INTEREST

Not stated

GUIDELINE STATUS

This is the current release of the guideline.

Please visit the Cancer Care Ontario Web site for details on any new evidence that has emerged and implications to the guidelines.

GUIDELINE AVAILABILITY

Electronic copies: Available in Portable Document Format (PDF) from the Cancer Care Ontario Web site.

AVAILABILITY OF COMPANION DOCUMENTS

The following is available:

  • Browman GP, Levine MN, Mohide EA, Hayward RSA, Pritchard KI, Gafni A, et al. The practice guidelines development cycle: a conceptual tool for practice guidelines development and implementation. J Clin Oncol 1995;13(2):502-12.

PATIENT RESOURCES

None available

NGC STATUS

This NGC summary was completed by ECRI on October 29, 2006. The information was verified by the guideline developer on November 24, 2006.

COPYRIGHT STATEMENT

This NGC summary is based on the original guideline, which is subject to the guideline developer's copyright restrictions. Please refer to the Copyright and Disclaimer Statements posted at the Program in Evidence-Based Care section of the Cancer Care Ontario Web site.

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DISCLAIMER

NGC DISCLAIMER

The National Guideline Clearinghouse™ (NGC) does not develop, produce, approve, or endorse the guidelines represented on this site.

All guidelines summarized by NGC and hosted on our site are produced under the auspices of medical specialty societies, relevant professional associations, public or private organizations, other government agencies, health care organizations or plans, and similar entities.

Guidelines represented on the NGC Web site are submitted by guideline developers, and are screened solely to determine that they meet the NGC Inclusion Criteria which may be found at http://www.guideline.gov/about/inclusion.aspx .

NGC, AHRQ, and its contractor ECRI Institute make no warranties concerning the content or clinical efficacy or effectiveness of the clinical practice guidelines and related materials represented on this site. Moreover, the views and opinions of developers or authors of guidelines represented on this site do not necessarily state or reflect those of NGC, AHRQ, or its contractor ECRI Institute, and inclusion or hosting of guidelines in NGC may not be used for advertising or commercial endorsement purposes.

Readers with questions regarding guideline content are directed to contact the guideline developer.
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