Various Imaging Modality in Ovarian Cancer

Ovarian cancer (OC) is the most lethal gynecological cancer worldwide. Complete cytoreduction with platinum based chemotherapy is the standard of care. Despite this, many patients recur predominantly in the peritoneal cavity. With advent of HIPEC, 5-yr survival has improved significantly. PCI is a major determinant for survival. Surgical PCI as advocated by Paul Sugarbaker provides a systematic and region wise assessment of disease. One of the indications for Neo-adjuvant chemotherapy is high PCI especially bulky upper abdomen disease including the sub diaphragmatic region and pleural effusion with high lymph nodal burden. No single imaging modality predicts the PCI accurately. This study was done to compare two imaging modalities namely CECT and PET-CT for calculating pre-op PCI and to compare with surgical PCI at the time of operation. Also, region wise concordance between imaging modalities and surgical PCI was done. If predicted PCI is high and involving critical locations that particular group of patients can be avoided unnecessary exploration and patient can be planned for neoadjuvant chemotherapy.