Ovarian Cancer from Anatomy to Functional Imaging

Abstract

Ovarian carcinoma is the most common cause of death from a gynecologic malignancy with more than 2/3 of patients having peritoneal involvement at the time of diagnosis. Treatment is principally dependent on stage and extent of disease and center expertise. Patients with advanced disease are treated either by primary cytoreductive surgery (debulking) followed by adjuvant chemotherapy, or neoadjuvant chemotherapy prior to debulking surgery. Imaging at the time of initial presentation has become critical in the selection of patients who may benefit from neoadjuvant chemotherapy instead of primary debulking surgery. Moreover, with the development of neoadjuvant treatment and molecularly targeted drug, evaluation of treatment response has becoming both critical and challenging. Indeed, evaluating early tumor changes, for example, relies more on functional (assessment of tumor vascularity, necrosis, etc.) rather than macroscopic changes in tumor size. This highlights a need for novel non-invasive biomarkers to allow implementation of personalized treatment. Thus, in this review, we focus on the advances of imaging in the diagnosis and management of ovarian cancer including functional imaging and radiogenomics.