Patient satisfaction with ultrasound, whole-body CT and whole-body diffusion-weighted MRI for pre-operative ovarian cancer staging : a multicenter prospective cross-sectional survey

• Background In addition to the diagnostic accuracy of imaging methods, patient-reported satisfaction with imaging methods is important. Objective To report a secondary outcome of the prospective international multicenter Imaging Study in Advanced ovArian Cancer (ISAAC Study), detailing patients’ experience with abdomino-pelvic ultrasound, whole-body contrast-enhanced computed tomography (CT), and whole-body diffusion-weighted magnetic resonance imaging (WB-DWI/MRI) for pre-operative ovarian cancer work-up. Methods In total, 144 patients with suspected ovarian cancer at four institutions in two countries (Italy, Czech Republic) underwent ultrasound, CT, and WB-DWI/ MRI for pre-operative work-up between January 2020 and November 2022. After having undergone all three examinations, the patients filled in a questionnaire evaluating their overall experience and experience in five domains: preparation before the examination, duration of examination, noise during the procedure, radiation load of CT, and surrounding space. Pain perception, examination-related patient-perceived unexpected, unpleasant, or dangerous events (‘adverse events’), and preferred method were also noted. Results Ultrasound was the preferred method by 49% (70/144) of responders, followed by CT (38%, 55/144), and WB-DWI/MRI (13%, 19/144) (p<0.001). The poorest experience in all domains was reported for WB-DWI/ MRI, which was also associated with the largest number of patients who reported adverse events (eg, dyspnea). Patients reported higher levels of pain during the ultrasound examination than during CT and WB-DWI/MRI (p<0.001): 78% (112/144) reported no pain or mild pain, 19% (27/144) moderate pain, and 3% (5/144) reported severe pain (pain score >7 of 10) during the ultrasound examination. We did not identify any factors related to patients' preferred method.for diagnosing malignant ovarian tumors3 but has rarely been used for pre-operative ovarian cancer work-up.4–7 In 2022, the results of a prospective single-unit study indicated that ultrasound might be an alternative to CT and whole-body diffusion-weighted (WB-DWI)/ MRI for ovarian cancer work-up and prediction of tumor resectability.8 In the recently published European Society of Gynecological Oncology/European Society of Medical Oncology/European Society of Pathology (ESGO/ESMO/ESP) consensus conference recommendations on ovarian cancer, ultrasound is suggested to be an effective alternative to CT, MRI and PET-CT to assess tumor extent and tumor resectability in the pelvis and abdomen.2 In addition to diagnostic accuracy and costs of an imaging method, patient acceptance and preference are important before an imaging test is implemented in clinical practice.9 10 Although there is evidence regarding patients’ experience of and satisfaction with ultrasound,11 12 CT,13–17 and WB-DWI/MRI,16 18–20 little is known about how these three imaging modalities compare when applied in the same patient. Many factors can influence a patient’s experience with an imaging examination—for example, preparation for, and duration of, the examination; use of contrast agent (especially iodinated contrast agent); radiation dose (which depends on the duration of radiation exposure, distance from the radiation source, and physical shielding); noise, feeling of claustrophobia, and occurrence of unexpected unpleasant or dangerous events (adverse events).21–25 The aim of this study is to report a secondary outcome of the prospective, multicentric Imaging Study in Advanced ovArian Cancer (ISAAC Study)—namely, patients’ experience with ultrasound, CT, and WB-DWI/MRI for pre-operative estimation of the extent of ovarian cancer.

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MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Radiologi och bildbehandling (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Radiology, Nuclear Medicine and Medical Imaging (hsv//eng)

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